Healthcare Provider Details

I. General information

NPI: 1851995153
Provider Name (Legal Business Name): BHUMI PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2020
Last Update Date: 11/26/2020
Certification Date: 11/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 DORCHESTER RD STE 107
CHATTANOOGA TN
37405-4431
US

IV. Provider business mailing address

2710 22ND ST NW
CLEVELAND TN
37312-2309
US

V. Phone/Fax

Practice location:
  • Phone: 423-267-5060
  • Fax:
Mailing address:
  • Phone: 423-310-4148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number43492
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: