MEDICARE: DR. KISHAN SNEHAL PATEL PHARM.D.

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	2019030629	MO

General Provider Information

NPI Number	:	1306491279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KISHAN SNEHAL PATEL PHARM.D.

Provider Business Mailing Address
First Line	:	2855 VETERANS MEMORIAL PKWY
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-3202
Country	:	US
Telephone Number	:	636-925-1143
Fax Number	:

Provider Business Practice Location Address
First Line	:	2855 VETERANS MEMORIAL PKWY
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-3202
Country	:	US
Telephone Number	:	636-925-1143
Fax Number	:

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

Provider Enumeration Date	:	08/07/2019
Last Update Date	:	08/07/2019

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