Healthcare Provider Details

I. General information

NPI: 1891107678
Provider Name (Legal Business Name): PATRICK MONTE IGNACIO PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N WINSTEAD AVE
ROCKY MOUNT NC
27804-2235
US

IV. Provider business mailing address

PO BOX 8573
ROCKY MOUNT NC
27804-1573
US

V. Phone/Fax

Practice location:
  • Phone: 252-459-5544
  • Fax: 252-459-9300
Mailing address:
  • Phone: 252-459-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22979
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: