Provider Demographics
NPI:1013597962
Name:PATEL, BHAVANA N (RPH)
Entity Type:Individual
Prefix:
First Name:BHAVANA
Middle Name:N
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 MEADOWRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-4195
Mailing Address - Country:US
Mailing Address - Phone:215-290-3111
Mailing Address - Fax:
Practice Address - Street 1:305 SECOND AVE STE 204
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-2682
Practice Address - Country:US
Practice Address - Phone:484-978-9009
Practice Address - Fax:484-978-9008
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039621L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist