Provider Demographics
NPI:1831700905
Name:BHATT, VIRAL (PHARMACIST)
Entity type:Individual
Prefix:
First Name:VIRAL
Middle Name:
Last Name:BHATT
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5451 BOWMAN RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-5783
Mailing Address - Country:US
Mailing Address - Phone:478-474-3064
Mailing Address - Fax:
Practice Address - Street 1:5451 BOWMAN RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-5783
Practice Address - Country:US
Practice Address - Phone:478-474-3064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist