Provider Demographics
NPI:1720385966
Name:PATEL, ASHISH B (RPH)
Entity Type:Individual
Prefix:
First Name:ASHISH
Middle Name:B
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 1:1103 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-1322
Mailing Address - Country:US
Mailing Address - Phone:864-210-1811
Mailing Address - Fax:864-210-1810
Practice Address - Street 1:1103 N MAIN ST STE E
Practice Address - Street 2:
Practice Address - City:FOUNTAIN INN
Practice Address - State:SC
Practice Address - Zip Code:29644-1336
Practice Address - Country:US
Practice Address - Phone:864-210-1811
Practice Address - Fax:864-210-1810
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist