Provider Demographics
NPI:1417712191
Name:PATEL, RAKESH R (RPH)
Entity Type:Individual
Prefix:
First Name:RAKESH
Middle Name:R
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 1:9915 CLARKES VIEW PL NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-7235
Mailing Address - Country:US
Mailing Address - Phone:704-728-9355
Mailing Address - Fax:
Practice Address - Street 1:2760 CELANESE RD STE 102
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-9406
Practice Address - Country:US
Practice Address - Phone:803-981-5330
Practice Address - Fax:803-981-5333
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9680183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist