Provider Demographics
NPI:1023465556
Name:MEHTA, RACHIT M (PHARMD)
Entity type:Individual
Prefix:
First Name:RACHIT
Middle Name:M
Last Name:MEHTA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 W 24TH ST
Mailing Address - Street 2:APT #209
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6063
Mailing Address - Country:US
Mailing Address - Phone:928-210-9350
Mailing Address - Fax:
Practice Address - Street 1:1150 W 8TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-2863
Practice Address - Country:US
Practice Address - Phone:928-783-6834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-13
Last Update Date:2016-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZI012368390200000X
MEPI13145390200000X
AZS022180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No183500000XPharmacy Service ProvidersPharmacist