Provider Demographics
NPI:1104420447
Name:DICORATO, BHUMY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BHUMY
Middle Name:
Last Name:DICORATO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BHUMY
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8314 SMOKETREE CIR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-9019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 DORCHESTER RD STE 117
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-4432
Practice Address - Country:US
Practice Address - Phone:423-267-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist