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General NPI Number Information
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NPI Number | 1578163655
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Entity Type | Individual
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Provider Name | SONAL B PATEL
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Gender | Female
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 1450 BOWENS MILL RD SE
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City | DOUGLAS
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State | GA
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Zip | 31533-1500
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Country | US
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Telephone | 912-384-5492
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Fax | 912-384-5528
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Provider Business Mailing Address
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Address Line | 1155 WALKER ST W
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City | DOUGLAS
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State | GA
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Zip | 31533-3445
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Country | US
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Telephone | 912-592-3573
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Fax | 912-384-5528
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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 | RPH020798
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License Number State | GA
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