Healthcare Provider Details
I. General information
NPI: 1700747458
Provider Name (Legal Business Name): KRUTI PATEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
619 19TH ST S # JT1728
BIRMINGHAM AL
35233-1900
US
IV. Provider business mailing address
619 19TH ST S # JT1728
BIRMINGHAM AL
35233-1900
US
V. Phone/Fax
- Phone: 205-934-3411
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 21678 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: