Provider Demographics
NPI:1619099165
Name:RUSS, SABRINA NEVETTE (PHARMD,NBC-HWC)
Entity type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:NEVETTE
Last Name:RUSS
Suffix:
Gender:F
Credentials:PHARMD,NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 FOX SQUIRREL CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-4481
Mailing Address - Country:US
Mailing Address - Phone:803-602-6777
Mailing Address - Fax:803-602-6777
Practice Address - Street 1:364 FOX SQUIRREL CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-4481
Practice Address - Country:US
Practice Address - Phone:803-602-6777
Practice Address - Fax:803-602-6777
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-4042698171400000X
SC10006183500000X, 1835G0303X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness Coach
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Multi-Specialty