Provider Demographics
NPI:1205040763
Name:PATEL, KIRIT G (RPH)
Entity type:Individual
Prefix:
First Name:KIRIT
Middle Name:G
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 1:11501 SIR SPENCER WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-6003
Mailing Address - Country:US
Mailing Address - Phone:301-916-2581
Mailing Address - Fax:
Practice Address - Street 1:RITE AID PHARMACY 3790
Practice Address - Street 2:8048 NEW HAMPSHIRE AVE
Practice Address - City:LANGLEY PARK
Practice Address - State:MD
Practice Address - Zip Code:20783-6003
Practice Address - Country:US
Practice Address - Phone:301-439-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist