Provider Demographics
NPI:1760893986
Name:BAMBRAH, DARSHAN SINGH (RPH)
Entity Type:Individual
Prefix:MR
First Name:DARSHAN
Middle Name:SINGH
Last Name:BAMBRAH
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 1:33196 LISA LN
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-5598
Mailing Address - Country:US
Mailing Address - Phone:440-498-0902
Mailing Address - Fax:440-248-9445
Practice Address - Street 1:33196 LISA LN
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-5598
Practice Address - Country:US
Practice Address - Phone:440-498-0902
Practice Address - Fax:440-248-9445
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03211464183500000X
VA4949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist