Provider Demographics
NPI:1376099309
Name:PATEL, HARSH VIPULKUMAR
Entity Type:Individual
Prefix:
First Name:HARSH
Middle Name:VIPULKUMAR
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1943 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2417
Mailing Address - Country:US
Mailing Address - Phone:980-880-6400
Mailing Address - Fax:980-880-6403
Practice Address - Street 1:1943 E 7TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2417
Practice Address - Country:US
Practice Address - Phone:980-880-6400
Practice Address - Fax:980-880-6403
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist