Provider Demographics
NPI:1699349027
Name:PATEL, AMIT RAMANBHAI (RPH)
Entity type:Individual
Prefix:
First Name:AMIT
Middle Name:RAMANBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12019 OLDEN CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-6417
Mailing Address - Country:US
Mailing Address - Phone:704-650-3846
Mailing Address - Fax:
Practice Address - Street 1:28600 CHAGRIN BLVD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4532
Practice Address - Country:US
Practice Address - Phone:216-831-1616
Practice Address - Fax:216-378-1787
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14255183500000X
SC11316183500000X
OH03440490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist