Provider Demographics
NPI:1497030464
Name:PATEL, VICKY CHANDRAKANT (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:MISS
First Name:VICKY
Middle Name:CHANDRAKANT
Last Name:PATEL
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6680 ATLANTA HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117
Mailing Address - Country:US
Mailing Address - Phone:334-409-0611
Mailing Address - Fax:334-409-5742
Practice Address - Street 1:6680 ATLANTA HIGHWAY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117
Practice Address - Country:US
Practice Address - Phone:334-409-0611
Practice Address - Fax:334-409-5742
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist