Provider Demographics
NPI:1104043009
Name:PATEL, RIMISHA M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:RIMISHA
Middle Name:M
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 1:315 LAHONTAN PASS
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1549
Mailing Address - Country:US
Mailing Address - Phone:404-680-2107
Mailing Address - Fax:770-814-8116
Practice Address - Street 1:315 LAHONTAN PASS
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1549
Practice Address - Country:US
Practice Address - Phone:404-680-2107
Practice Address - Fax:770-814-8116
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH020630183500000X
NJ28RI02602100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist