MEDICARE: MR. PIYUSH BHOLABHAI PATEL RPH

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	5302035101	MI

General Provider Information

NPI Number	:	1881727030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PIYUSH BHOLABHAI PATEL RPH

Provider Business Mailing Address
First Line	:	4542 GULL PRAIRIE PL 2B
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-3091
Country	:	US
Telephone Number	:	269-558-1518
Fax Number	:	269-552-9210

Provider Business Practice Location Address
First Line	:	4542 GULL PRAIRIE PL APT 2B
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-3091
Country	:	US
Telephone Number	:	269-552-1518
Fax Number	:	269-552-9210

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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