Provider Demographics
NPI:1881971752
Name:PATEL, KALPESHKUMAR RAMESHBHAI (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:KALPESHKUMAR
Middle Name:RAMESHBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1848 CLEAR BROOK CT
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2783
Mailing Address - Country:US
Mailing Address - Phone:423-505-7584
Mailing Address - Fax:423-629-0534
Practice Address - Street 1:3984 RINGGOLD RD
Practice Address - Street 2:
Practice Address - City:EAST RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37412-1659
Practice Address - Country:US
Practice Address - Phone:423-629-0091
Practice Address - Fax:423-629-0534
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN34905183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist