NPIMap

Organization Active NPI

Stanleyville Family Pharmacy

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Winston Salem, NC
National Provider Identifier
1407009780
Registry record updated Oct 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
Legal business name
STANLEYVILLE FAMILY PHARMACY
Practice address
6143 University Parkway
Winston Salem, NC 27105
Phone
(336) 529-6016
Fax
(336) 529-6017
NPI assigned
Oct 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Russell Warren Patterson, PHARM D.
Title
President/Pharmacist
Phone
(336) 529-6016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 1835P0018X Primary

Addresses

Primary practice location

6143 University Parkway
Winston Salem, NC 27105

Mailing address

6143 University Parkway
Winston Salem, NC 27105
Phone (336) 529-6016

National Provider Directory

National Provider Directory
Tax ID family
Stanleyville Family Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225324800000",
    "number": "1407009780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6143 UNIVERSITY PARKWAY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27105",
            "telephone_number": "336-529-6016",
            "fax_number": "336-529-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 UNIVERSITY PARKWAY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27105",
            "telephone_number": "336-529-6016",
            "fax_number": "336-529-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEYVILLE FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-30",
        "last_updated": "2008-10-30",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "336-529-6016",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.