Provider Demographics
NPI:1083016158
Name:DHARAJ BROS LLC
Entity Type:Organization
Organization Name:DHARAJ BROS LLC
Other - Org Name:CARRICK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBARIYA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:412-209-0996
Mailing Address - Street 1:2717 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-2047
Mailing Address - Country:US
Mailing Address - Phone:412-206-0996
Mailing Address - Fax:412-207-8170
Practice Address - Street 1:2717 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-2047
Practice Address - Country:US
Practice Address - Phone:412-206-0996
Practice Address - Fax:412-207-8170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-20
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP4825053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029728890001Medicaid
2148022OtherPK