Provider Demographics
NPI:1407168578
Name:PATEL, AMIT (RPH)
Entity Type:Individual
Prefix:
First Name:AMIT
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 1:1875 ELECTRIC RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7207
Mailing Address - Country:US
Mailing Address - Phone:540-387-1969
Mailing Address - Fax:540-387-5839
Practice Address - Street 1:1875 ELECTRIC RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7207
Practice Address - Country:US
Practice Address - Phone:540-387-1969
Practice Address - Fax:540-387-5839
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008037183500000X
TX46576183500000X
VA0202211639183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist