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General NPI Number Information
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NPI Number | 1992115588
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Entity Type | Individual
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Provider Name | AMBRISH PATEL PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 190 THOMAS JOHNSON DR STE 3
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City | FREDERICK
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State | MD
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Zip | 21702-4879
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Country | US
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Telephone | 240-422-8433
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Fax | 301-662-0001
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Provider Business Mailing Address
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Address Line | 1205 E PINE ST KMART PHARNACY
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City | DEMING
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State | NM
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Zip | 88030-7038
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Country | US
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Telephone | 575-544-9008
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Fax | 575-544-4465
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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 | RP00007752
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 50775
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 24518
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License Number State | MD
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