Provider Demographics
NPI:1881017291
Name:MEHTA, PRITAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:PRITAL
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 RIVERCHASE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2493
Mailing Address - Country:US
Mailing Address - Phone:803-970-6440
Mailing Address - Fax:
Practice Address - Street 1:1417 RIVERCHASE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2493
Practice Address - Country:US
Practice Address - Phone:803-970-6440
Practice Address - Fax:803-970-6441
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23188183500000X
SC14095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist