Provider Demographics
NPI:1194116293
Name:PATEL, HARDIK (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:HARDIK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 STONECREEK CT
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-3114
Mailing Address - Country:US
Mailing Address - Phone:215-353-8489
Mailing Address - Fax:
Practice Address - Street 1:626 CENTRE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:PA
Practice Address - Zip Code:17921-1332
Practice Address - Country:US
Practice Address - Phone:215-353-8489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445469183500000X
NJ28RI03419600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist