Healthcare Provider Details

I. General information

NPI: 1962937649
Provider Name (Legal Business Name): CRISTINA REYES PATILLE PHARMD, BCPS, CPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 GREEN VALLEY RD
GREENSBORO NC
27408-7019
US

IV. Provider business mailing address

709 GREEN VALLEY RD
GREENSBORO NC
27408-7019
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-8138
  • Fax: 336-547-1769
Mailing address:
  • Phone: 336-832-8138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number25996
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: