Provider Demographics
NPI:1619157252
Name:PATEL-PUROHIT, AGNES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AGNES
Middle Name:
Last Name:PATEL-PUROHIT
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 1:324 BARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35210-3453
Mailing Address - Country:US
Mailing Address - Phone:205-986-6287
Mailing Address - Fax:
Practice Address - Street 1:8551 WHITFIELD AVE
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:AL
Practice Address - Zip Code:35094-7560
Practice Address - Country:US
Practice Address - Phone:205-699-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist