South Park Family Pharmacy LLC
NPI 1295173573 · Community/Retail Pharmacy · Winston-Salem, NC
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
South Park Family Pharmacy LLC is a Community/Retail Pharmacy organization in Winston-Salem, NC (NPI 1295173573).
Provider details
- NPI number
- 1295173573
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Russell Patterson, Member/Manager(336) 853-2744
- License
- 11570 (NC)
Specialties & taxonomies
Suppliers
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- South Park Family Pharmacy
- Doing business as
- South Park Family Pharmacy
Registry dates
- Enumerated
- 2013-06-10
- Last updated
- 2023-03-14
- Certified
- 2023-03-14
Frequently asked questions
- What is South Park Family Pharmacy LLC's NPI number?
- South Park Family Pharmacy LLC's National Provider Identifier (NPI) is 1295173573, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is South Park Family Pharmacy LLC?
- South Park Family Pharmacy LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is South Park Family Pharmacy LLC located?
- South Park Family Pharmacy LLC's practice location on file with NPPES is 1215 a West Clemmonsville Road, Winston-Salem, NC 27127-4790.
- What is South Park Family Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for South Park Family Pharmacy LLC is (336) 853-2744.
- Does South Park Family Pharmacy LLC accept Medicare?
- South Park Family Pharmacy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for South Park Family Pharmacy LLC?
- The authorized official listed on South Park Family Pharmacy LLC's NPPES record is Russell Patterson, Member/Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is South Park Family Pharmacy LLC's NPI active?
- Yes — South Park Family Pharmacy LLC's NPI (1295173573) is active in the NPPES registry as of the last update on 2023-03-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.