Provider Demographics
NPI:1083958532
Name:PATEL, PARITA J
Entity Type:Individual
Prefix:
First Name:PARITA
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 MARCHBANKS AVE
Mailing Address - Street 2:APT # 6B
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-2118
Mailing Address - Country:US
Mailing Address - Phone:864-642-0277
Mailing Address - Fax:
Practice Address - Street 1:2420 MARCHBANKS AVE
Practice Address - Street 2:APT # 6B
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2118
Practice Address - Country:US
Practice Address - Phone:864-642-0277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-22
Last Update Date:2012-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist