Provider Demographics
NPI:1285254334
Name:PATEL, TRUSHA KETAN (PHARMD)
Entity type:Individual
Prefix:
First Name:TRUSHA
Middle Name:KETAN
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12280 MCCOY WAY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-1481
Mailing Address - Country:US
Mailing Address - Phone:770-596-8785
Mailing Address - Fax:
Practice Address - Street 1:5665 HIGHWAY 9 N
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-3959
Practice Address - Country:US
Practice Address - Phone:770-752-5388
Practice Address - Fax:770-752-0143
Is Sole Proprietor?:No
Enumeration Date:2020-04-19
Last Update Date:2020-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0211391835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist