Provider Demographics
NPI:1336749647
Name:PATEL, AMI V (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:V
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 W BROADWAY APT 9302
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-7908
Mailing Address - Country:US
Mailing Address - Phone:608-347-7894
Mailing Address - Fax:
Practice Address - Street 1:3001 W BROADWAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3106
Practice Address - Country:US
Practice Address - Phone:573-445-3708
Practice Address - Fax:573-445-3813
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007022171183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist