Healthcare Provider Details

I. General information

NPI: 1811590664
Provider Name (Legal Business Name): RAHULKUMAR MANGUBHAI PATEL PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CHARWOOD DR
ABINGDON VA
24210-2576
US

IV. Provider business mailing address

2074 POLO GARDENS DR APT 205
WELLINGTON FL
33414-2010
US

V. Phone/Fax

Practice location:
  • Phone: 276-676-2900
  • Fax:
Mailing address:
  • Phone: 812-454-2163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202218758
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS65632
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0000044618
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number021679
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: