MEDICARE: PATRICIA K WORTHINGTON RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	7980	NC

General Provider Information

NPI Number	:	1821380510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA K WORTHINGTON RPH

Provider Business Mailing Address
First Line	:	9600 FALLS OF THE NEUSE RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-0000
Country	:	US
Telephone Number	:	919-845-0613
Fax Number	:	919-846-5369

Provider Business Practice Location Address
First Line	:	9600 FALLS OF THE NEUSE RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-0000
Country	:	US
Telephone Number	:	919-845-0613
Fax Number	:	919-846-5369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2011
Last Update Date	:	05/12/2011

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