Provider Demographics
NPI:1265713291
Name:PATEL, BIJALKUMAR JAYANTILAL (RPH)
Entity type:Individual
Prefix:
First Name:BIJALKUMAR
Middle Name:JAYANTILAL
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 1:1502 OXFORD DR STE 150
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8095
Mailing Address - Country:US
Mailing Address - Phone:502-863-3784
Mailing Address - Fax:502-863-3789
Practice Address - Street 1:2209 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1306
Practice Address - Country:US
Practice Address - Phone:859-269-8832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-05
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40142183500000X
MI5302036625183500000X
KY013544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist