MEDICARE: MR. HASMUKH C PATEL PHARMACIST

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	RPH014908	GA

General Provider Information

NPI Number	:	1679730097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HASMUKH C PATEL PHARMACIST

Provider Business Mailing Address
First Line	:	2650 CRUSE RD
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30044-2658
Country	:	US
Telephone Number	:	770-921-8514
Fax Number	:	770-921-0372

Provider Business Practice Location Address
First Line	:	2650 CRUSE RD
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30044-2658
Country	:	US
Telephone Number	:	770-921-8514
Fax Number	:	770-921-0372

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

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	05/22/2008

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