Provider Demographics
NPI:1396345757
Name:PATEL, PARIN (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:PARIN
Middle Name:
Last Name:PATEL
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 1:1120 PEARL MIST DR SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-5494
Mailing Address - Country:US
Mailing Address - Phone:770-559-5688
Mailing Address - Fax:
Practice Address - Street 1:2912 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3148
Practice Address - Country:US
Practice Address - Phone:770-225-1408
Practice Address - Fax:678-344-0348
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023172183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist