MEDICARE: DR. MANALI PATEL PHARMD, MBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	41789	TN

General Provider Information

NPI Number	:	1548769086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANALI PATEL PHARMD, MBA

Provider Business Mailing Address
First Line	:	13782 LAKE SHORE DR
Second Line	:
City	:	CLIVE
State	:	IA
Zip	:	50325-8833
Country	:	US
Telephone Number	:	515-313-3063
Fax Number	:

Provider Business Practice Location Address
First Line	:	13782 LAKE SHORE DR
Second Line	:
City	:	CLIVE
State	:	IA
Zip	:	50325-8833
Country	:	US
Telephone Number	:	515-313-3063
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2018
Last Update Date	:	02/11/2018

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