Provider Demographics
NPI:1043495047
Name:KALPANA PATEL B PHARM INC
Entity type:Organization
Organization Name:KALPANA PATEL B PHARM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KALPANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-319-6939
Mailing Address - Street 1:3805 SAN DIMAS ST
Mailing Address - Street 2:STE A
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5724
Mailing Address - Country:US
Mailing Address - Phone:661-325-7979
Mailing Address - Fax:661-325-8181
Practice Address - Street 1:3805 SAN DIMAS ST
Practice Address - Street 2:STE A
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5724
Practice Address - Country:US
Practice Address - Phone:661-325-7979
Practice Address - Fax:661-325-8181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X, 3336L0003X
CA489223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5629069OtherNCPDP PROVIDER IDENTIFICATION NUMBER
6081230001Medicare NSC