Provider Demographics
NPI:1497054209
Name:GANDHI, YOGESH (RPH)
Entity Type:Individual
Prefix:
First Name:YOGESH
Middle Name:
Last Name:GANDHI
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 1:2200 ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9126
Mailing Address - Country:US
Mailing Address - Phone:252-215-0242
Mailing Address - Fax:
Practice Address - Street 1:5016 OLD TAR RD
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8436
Practice Address - Country:US
Practice Address - Phone:252-361-0649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15220183500000X
TX37495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist