Provider Demographics
NPI:1780136754
Name:PATEL, JIGNESH MUKESH (RPH)
Entity type:Individual
Prefix:
First Name:JIGNESH
Middle Name:MUKESH
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 1:2528 BOILING SPRINGS RD STE D
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-5361
Mailing Address - Country:US
Mailing Address - Phone:732-331-2250
Mailing Address - Fax:864-256-3499
Practice Address - Street 1:2528 BOILING SPRINGS RD STE D
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316-5361
Practice Address - Country:US
Practice Address - Phone:732-331-2250
Practice Address - Fax:864-515-2600
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2020-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59736183500000X
SC42387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist