MEDICARE: RICHA PATEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5302045408	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NA	OTHER		NA

General Provider Information

NPI Number	:	1013407550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHA PATEL

Provider Business Mailing Address
First Line	:	309 N MAIN ST
Second Line	:
City	:	FRANKENMUTH
State	:	MI
Zip	:	48734-1113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	309 N MAIN ST
Second Line	:
City	:	FRANKENMUTH
State	:	MI
Zip	:	48734-1113
Country	:	US
Telephone Number	:	989-652-2613
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2018
Last Update Date	:	05/10/2018

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Directions to “ RICHA PATEL ” Practice Location

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