Organization · Type 2 NPI

South Park Family Pharmacy LLC

Community/Retail Pharmacy · Winston-Salem, NC

NPI number 1295173573 Active

Practice location

1215 A West Clemmonsville Road
Winston-Salem, NC 27127-4790

Call (336) 853-2744 Map

Fax (336) 853-5915

Mailing address

1107 W Market Center Dr
High Point, NC 27260-1642

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	11570 (NC)
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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NPI record

NPI: 1295173573
Entity type: Organization (Type 2)
Issued: Jun 10, 2013
Last updated: Jun 18, 2026
Status: Active

Other names

<unavail>
South Park Family Pharmacy · doing business as
South Park Family Pharmacy · doing business as

Authorized official

Russell Warren Patterson, PHARM D.
Member/manager
(336) 817-6794

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1295173573

South Park Family Pharmacy LLC's National Provider Identifier is 1295173573, issued on Jun 10, 2013. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Winston-Salem, NC. The record was last updated on Jun 18, 2026.