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NPI Code Detail

MEDICARE: PRERANA PATEL PHARMD

MEDICARE:   PRERANA  PATEL  PHARMD
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
1183500000XPharmacistRPH029619GA

General Provider Information

NPI Number : 1235748989
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRERANA PATEL PHARMD
Provider Business Mailing Address
First Line : 5415 HUNTINGTON MIST DR
Second Line :
City : STONE MOUNTAIN
State : GA
Zip : 30087-3339
Country : US
Telephone Number : 678-602-7488
Fax Number :
Provider Business Practice Location Address
First Line : 2325 PLEASANT HILL RD
Second Line :
City : DULUTH
State : GA
Zip : 30096-1753
Country : US
Telephone Number : 678-602-7488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2020
Last Update Date : 07/29/2020

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Directions to “ PRERANA PATEL PHARMD” Practice Location

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