Provider Demographics
NPI:1659404903
Name:PATEL, MAHENDRA S (RPH)
Entity Type:Individual
Prefix:
First Name:MAHENDRA
Middle Name:S
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 1:1124 GROGANS MILL DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-9472
Mailing Address - Country:US
Mailing Address - Phone:919-413-2120
Mailing Address - Fax:919-462-8936
Practice Address - Street 1:1945 HIGH HOUSE RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8452
Practice Address - Country:US
Practice Address - Phone:919-467-6064
Practice Address - Fax:919-462-8936
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist