Provider Demographics
NPI:1811590664
Name:PATEL, RAHULKUMAR MANGUBHAI (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:RAHULKUMAR
Middle Name:MANGUBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 EDMOND DR APT 1
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-5002
Mailing Address - Country:US
Mailing Address - Phone:812-454-2163
Mailing Address - Fax:
Practice Address - Street 1:101 CHARWOOD DR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2576
Practice Address - Country:US
Practice Address - Phone:276-676-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000044618183500000X
KY021679183500000X
VA0202218758183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist