Provider Demographics
NPI:1023784667
Name:PATEL, HARSH JITENDRAKUMAR (PHARMD)
Entity type:Individual
Prefix:
First Name:HARSH
Middle Name:JITENDRAKUMAR
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3658 S NEW HOPE RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-8325
Mailing Address - Country:US
Mailing Address - Phone:704-823-1839
Mailing Address - Fax:
Practice Address - Street 1:3658 S NEW HOPE RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-8325
Practice Address - Country:US
Practice Address - Phone:704-823-1838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist