Healthcare Provider Details

I. General information

NPI: 1962844258
Provider Name (Legal Business Name): KINJALBEN PRAKASHKUMAR PATEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MERCANTILE PL
FORT MILL SC
29715-0136
US

IV. Provider business mailing address

500 MERCANTILE PL
FORT MILL SC
29715-0136
US

V. Phone/Fax

Practice location:
  • Phone: 803-547-0585
  • Fax:
Mailing address:
  • Phone: 803-547-0585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23502
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: