Healthcare Provider Details

I. General information

NPI: 1215597026
Provider Name (Legal Business Name): KRINA MANUBHAI PATEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2019
Last Update Date: 06/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1874 PIEDMONT AVE NE STE 100A
ATLANTA GA
30324-4816
US

IV. Provider business mailing address

1874 PIEDMONT AVE NE STE 100A
ATLANTA GA
30324-4816
US

V. Phone/Fax

Practice location:
  • Phone: 404-733-6800
  • Fax: 404-733-5848
Mailing address:
  • Phone: 404-733-6800
  • Fax: 404-733-5848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH029010
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: