Provider Demographics
NPI:1861137515
Name:BHAGAT, UMANG (RPH)
Entity type:Individual
Prefix:
First Name:UMANG
Middle Name:
Last Name:BHAGAT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01850-1252
Mailing Address - Country:US
Mailing Address - Phone:978-453-0820
Mailing Address - Fax:978-441-3974
Practice Address - Street 1:1161 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01850-1252
Practice Address - Country:US
Practice Address - Phone:978-453-0820
Practice Address - Fax:978-441-3974
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH240479183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist