Provider Demographics
NPI:1376876060
Name:PATEL, VIRBALA A (RPH)
Entity Type:Individual
Prefix:
First Name:VIRBALA
Middle Name:A
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 1:30334 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PRINCESS ANNE
Mailing Address - State:MD
Mailing Address - Zip Code:21853-1329
Mailing Address - Country:US
Mailing Address - Phone:410-651-3232
Mailing Address - Fax:
Practice Address - Street 1:2417 N SALISBURY BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2192
Practice Address - Country:US
Practice Address - Phone:410-651-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12284183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist