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General NPI Number Information
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NPI Number | 1538769906
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Entity Type | Individual
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Provider Name | PRATIK PATEL
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Gender | Male
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 1355 SANDHILL RD
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City | OREM
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State | UT
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Zip | 84058-7307
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Country | US
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Telephone | 801-221-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 302 S 740 E UNIT C103
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City | AMERICAN FORK
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State | UT
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Zip | 84003-3944
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Country | US
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Telephone | 551-666-0214
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 87772301701
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License Number State | UT
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