Provider Demographics
NPI:1114257334
Name:PATEL, CHIRAG (RPH)
Entity Type:Individual
Prefix:
First Name:CHIRAG
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6150 S 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-5004
Mailing Address - Country:US
Mailing Address - Phone:602-243-8517
Mailing Address - Fax:602-243-8520
Practice Address - Street 1:6150 S 35TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-5004
Practice Address - Country:US
Practice Address - Phone:602-243-8517
Practice Address - Fax:602-243-8520
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2019-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014938183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist