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General NPI Number Information
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NPI Number | 1700159696
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Entity Type | Organization
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Legal Business Name | MAHANT ELKTON LLC
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 111 S STUART AVE
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City | ELKTON
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State | VA
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Zip | 22827-1525
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Country | US
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Telephone | 540-298-9090
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Fax | 540-713-6399
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Provider Business Mailing Address
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Address Line | 111 S STUART AVE
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City | ELKTON
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State | VA
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Zip | 22827-1525
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Country | US
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Telephone | 540-298-9090
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Fax | 540-713-6399
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Authorized Official
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Title or Position | PHARMACIST - MANAGER PARTNER
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Name | DR. MITUL PATEL
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Credential | PHARMD
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Telephone | 804-591-5671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0201004445
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License Number State | VA
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