Provider Demographics
NPI:1093372930
Name:PATEL, HARDIKKUMAR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HARDIKKUMAR
Middle Name:
Last Name:PATEL
Suffix:
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 1:310 RACHEL ELIZABETH DR
Mailing Address - Street 2:
Mailing Address - City:STALLINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-8160
Mailing Address - Country:US
Mailing Address - Phone:229-343-4815
Mailing Address - Fax:
Practice Address - Street 1:3513 W HIGHWAY 74 STE B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-8677
Practice Address - Country:US
Practice Address - Phone:980-236-1966
Practice Address - Fax:833-574-0194
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-27
Last Update Date:2019-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist