Provider Demographics
NPI:1619127982
Name:PATEL, VINOD B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VINOD
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S GREENBRIER ST
Mailing Address - Street 2:UNIT 313
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-2730
Mailing Address - Country:US
Mailing Address - Phone:703-845-3661
Mailing Address - Fax:
Practice Address - Street 1:8644 SUDLEY RD
Practice Address - Street 2:SUITE 120
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4417
Practice Address - Country:US
Practice Address - Phone:703-334-5180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207340183500000X
NC18106183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist