Provider Demographics
NPI:1346491099
Name:MISTRY, BHAVIN KANTILAL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BHAVIN
Middle Name:KANTILAL
Last Name:MISTRY
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 1:3475 BENT TREE LN
Mailing Address - Street 2:APT 309
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2981
Mailing Address - Country:US
Mailing Address - Phone:330-344-1152
Mailing Address - Fax:
Practice Address - Street 1:400 WABASH AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2433
Practice Address - Country:US
Practice Address - Phone:330-344-1152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH.03328972-31835P0018X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist