Healthcare Provider Details

I. General information

NPI: 1528336104
Provider Name (Legal Business Name): HIRENKUMAR B PATEL PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W LANDIS AVE
VINELAND NJ
08360-8104
US

IV. Provider business mailing address

315 W LANDIS AVE
VINELAND NJ
08360-8104
US

V. Phone/Fax

Practice location:
  • Phone: 856-457-5171
  • Fax: 856-457-5291
Mailing address:
  • Phone: 856-457-5171
  • Fax: 856-457-5291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03395300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: