Provider Demographics
NPI:1508479387
Name:MEHTA, RACHANA (PHARMD)
Entity Type:Individual
Prefix:
First Name:RACHANA
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3352 N CHATHAM RD APT K
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2763
Mailing Address - Country:US
Mailing Address - Phone:347-553-6355
Mailing Address - Fax:
Practice Address - Street 1:400 ENGLAR RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6185
Practice Address - Country:US
Practice Address - Phone:347-553-6355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist