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
1	183500000X	Pharmacist	RPH029619	GA

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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