Provider Demographics
NPI:1447558358
Name:PATEL, BHAVESH (RPH)
Entity Type:Individual
Prefix:
First Name:BHAVESH
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 1:5 KEMPSEY WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6431
Mailing Address - Country:US
Mailing Address - Phone:919-452-3165
Mailing Address - Fax:
Practice Address - Street 1:121 FLEETWOOD DR
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-2019
Practice Address - Country:US
Practice Address - Phone:864-552-5192
Practice Address - Fax:864-442-5193
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC11517OtherPHARMACIST