Provider Demographics
NPI:1063856557
Name:PATEL, AJAYKUMAR B (RPH)
Entity Type:Individual
Prefix:MR
First Name:AJAYKUMAR
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:AJAY
Other - Middle Name:B
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:2011 STARR AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-2521
Mailing Address - Country:US
Mailing Address - Phone:419-720-1116
Mailing Address - Fax:419-386-0984
Practice Address - Street 1:2011 STARR AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-2521
Practice Address - Country:US
Practice Address - Phone:419-720-1116
Practice Address - Fax:419-386-0984
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH.03132424-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist