Provider Demographics
NPI:1508283508
Name:BHATT, RAJESH (RPH)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:BHATT
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 1:1133 E BUCKINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-1182
Mailing Address - Country:US
Mailing Address - Phone:480-652-9050
Mailing Address - Fax:
Practice Address - Street 1:3170 S HIGLEY RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-2051
Practice Address - Country:US
Practice Address - Phone:480-279-5517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS017573183500000X
CA32712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist