Provider Demographics
NPI:1932457496
Name:PATEL, PRACHI
Entity Type:Individual
Prefix:
First Name:PRACHI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 KREFELD GLEN DR
Mailing Address - Street 2:APT # 1405
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-6762
Mailing Address - Country:US
Mailing Address - Phone:614-360-8626
Mailing Address - Fax:
Practice Address - Street 1:121 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2936
Practice Address - Country:US
Practice Address - Phone:828-286-9133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist