Provider Demographics
NPI:1740748714
Name:PATEL, PARTH G (PHARMD)
Entity Type:Individual
Prefix:
First Name:PARTH
Middle Name:G
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 1:415 INDUSTRIAL AVE
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-2595
Mailing Address - Country:US
Mailing Address - Phone:641-236-6333
Mailing Address - Fax:
Practice Address - Street 1:415 INDUSTRIAL AVE
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2595
Practice Address - Country:US
Practice Address - Phone:641-236-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60550183500000X
IA22765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist