Healthcare Provider Details

I. General information

NPI: 1619099165
Provider Name (Legal Business Name): SABRINA NEVETTE RUSS PHARMD,NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 FOX SQUIRREL CIR
COLUMBIA SC
29209-4481
US

IV. Provider business mailing address

364 FOX SQUIRREL CIR
COLUMBIA SC
29209-4481
US

V. Phone/Fax

Practice location:
  • Phone: 803-602-6777
  • Fax: 803-602-6777
Mailing address:
  • Phone: 803-602-6777
  • Fax: 803-602-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-4042698
License Number State
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10006
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number10006
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number10006
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: