Provider Demographics
NPI:1174582944
Name:PATEL PHARMACY INC.
Entity type:Organization
Organization Name:PATEL PHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PARESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-721-7979
Mailing Address - Street 1:1228 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-2204
Mailing Address - Country:US
Mailing Address - Phone:661-721-7979
Mailing Address - Fax:661-721-7999
Practice Address - Street 1:1228 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2204
Practice Address - Country:US
Practice Address - Phone:661-721-7979
Practice Address - Fax:661-721-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA447810Medicaid
CA1321110001Medicare ID - Type UnspecifiedPHARMACY