Provider Demographics
NPI:1821389446
Name:DESAI, VAIDEHI S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:VAIDEHI
Middle Name:S
Last Name:DESAI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10140 GREEN LEVEL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8132
Mailing Address - Country:US
Mailing Address - Phone:919-460-4681
Mailing Address - Fax:919-469-0859
Practice Address - Street 1:10140 GREEN LEVEL CHURCH RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8132
Practice Address - Country:US
Practice Address - Phone:919-460-4681
Practice Address - Fax:919-469-0859
Is Sole Proprietor?:No
Enumeration Date:2011-04-30
Last Update Date:2011-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist