Provider Demographics
NPI:1457668907
Name:PATEL, RITESH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RITESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 COBB PKWY NW STE 107
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-2718
Mailing Address - Country:US
Mailing Address - Phone:770-800-0025
Mailing Address - Fax:
Practice Address - Street 1:2851 COBB PKWY NW STE 107
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152
Practice Address - Country:US
Practice Address - Phone:770-800-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-04
Last Update Date:2019-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 44825183500000X
GARPH030305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist