Provider Demographics
NPI:1639372774
Name:PATEL, NIMESH CHANDRAKANT (RPH)
Entity Type:Individual
Prefix:MR
First Name:NIMESH
Middle Name:CHANDRAKANT
Last Name:PATEL
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 1:4913 WESTMINSTER LN
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-2070
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1090 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1328
Practice Address - Country:US
Practice Address - Phone:844-443-6879
Practice Address - Fax:844-329-2447
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-22754183500000X
MI040973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03-1-22754OtherRPH LICENSE OHIO
MI040973OtherPHARMACY LICENSE