MEDICARE: DR. DHARMENDRAKUMAR B 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	13926	SC

General Provider Information

NPI Number	:	1538410394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DHARMENDRAKUMAR B PATEL PHARM D.

Provider Business Mailing Address
First Line	:	400 EMERALD RD N
Second Line	:	APT G-6
City	:	GREENWOOD
State	:	SC
Zip	:	29646-3063
Country	:	US
Telephone Number	:	201-744-0107
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 N CAMBRIDGE ST
Second Line	:
City	:	NINETY SIX
State	:	SC
Zip	:	29666-1011
Country	:	US
Telephone Number	:	864-543-2852
Fax Number	:	864-543-2982

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

Provider Enumeration Date	:	09/19/2012
Last Update Date	:	09/19/2012

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