Provider Demographics
NPI:1235954082
Name:PATEL, KHUSHBOO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KHUSHBOO
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 BLAKENHAM CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-7952
Mailing Address - Country:US
Mailing Address - Phone:404-403-7170
Mailing Address - Fax:
Practice Address - Street 1:11305 BELL RD STE 107
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-9504
Practice Address - Country:US
Practice Address - Phone:678-835-9997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist