Provider Demographics
NPI:1538410394
Name:PATEL, DHARMENDRAKUMAR B (PHARM D)
Entity type:Individual
Prefix:DR
First Name:DHARMENDRAKUMAR
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 EMERALD RD N
Mailing Address - Street 2:APT G-6
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-3063
Mailing Address - Country:US
Mailing Address - Phone:201-744-0107
Mailing Address - Fax:
Practice Address - Street 1:206 N CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:NINETY SIX
Practice Address - State:SC
Practice Address - Zip Code:29666-1011
Practice Address - Country:US
Practice Address - Phone:864-543-2852
Practice Address - Fax:864-543-2982
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist