Provider Demographics
NPI:1134590037
Name:PATEL, DIPALI HARISH
Entity type:Individual
Prefix:
First Name:DIPALI
Middle Name:HARISH
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 CHERRY RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3119
Mailing Address - Country:US
Mailing Address - Phone:803-328-6111
Mailing Address - Fax:803-329-6075
Practice Address - Street 1:609 CHERRY RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3119
Practice Address - Country:US
Practice Address - Phone:803-328-6111
Practice Address - Fax:803-329-6075
Is Sole Proprietor?:No
Enumeration Date:2015-10-18
Last Update Date:2015-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36015183500000X
FLPS50777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist