Provider Demographics
NPI:1669069522
Name:COMBS, PATRICK WAYNE JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:WAYNE
Last Name:COMBS
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 TWO CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5140
Mailing Address - Country:US
Mailing Address - Phone:304-654-0484
Mailing Address - Fax:401-652-1162
Practice Address - Street 1:2259 LANGHORNE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1114
Practice Address - Country:US
Practice Address - Phone:434-845-5953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist