=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659465151
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RADHEY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2006
-----------------------------------------------------
Last Update Date | 04/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 142 E MAIN ST
-----------------------------------------------------
City | SPARTANBURG
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29306-5113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-583-4521
-----------------------------------------------------
Fax | 864-582-0438
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 142 E MAIN ST
-----------------------------------------------------
City | SPARTANBURG
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29306-5113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-583-4521
-----------------------------------------------------
Fax | 864-582-0438
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. KUNTAL J PATEL
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 864-583-4521
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 15442
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------