Provider Demographics
NPI:1013239441
Name:PATEL, ANKIT J (RPH)
Entity Type:Individual
Prefix:
First Name:ANKIT
Middle Name:J
Last Name:PATEL
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 1:215 TYNDALE CT
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-6564
Mailing Address - Country:US
Mailing Address - Phone:980-333-3043
Mailing Address - Fax:
Practice Address - Street 1:480 RIVER HWY STE A
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6958
Practice Address - Country:US
Practice Address - Phone:980-333-3043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist