Provider Demographics
NPI:1467872572
Name:PATEL, SUHASKUMAR G (RPH)
Entity Type:Individual
Prefix:
First Name:SUHASKUMAR
Middle Name:G
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 1:64060 HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:LA
Mailing Address - Zip Code:70452-3267
Mailing Address - Country:US
Mailing Address - Phone:985-863-6444
Mailing Address - Fax:
Practice Address - Street 1:64060 HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:LA
Practice Address - Zip Code:70452-3267
Practice Address - Country:US
Practice Address - Phone:985-863-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020200183500000X
LA14181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist