Krishnan Patel, PHARM.D.
Individual provider Active NPI Pharmacist · Roebuck, SC
NPI 1871880245 · NPPES record last updated Jul 6, 2011
Key facts
- NPI
- 1871880245
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 11927 (SC)
- Practice address
- 1876 E Blackstock Rd
Roebuck, SC 29376-2700 - Phone
- (864) 574-8323
- NPI assigned
- Jul 6, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11927 | SC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freds Stores of Tennessee Inc | Past | Accepting new patients | |
| Freds Stores of Tennessee Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11927 | SC | Yes |
Addresses
Primary practice location
1876 E Blackstock Rd
Roebuck, SC 29376-2700
Mailing address
409 Danbury CT
Spartanburg, SC 29301-5381
Phone (864) 590-3965
Other providers in Roebuck, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.