Provider Demographics
NPI:1114077435
Name:SWADHARMA LLC
Entity Type:Organization
Organization Name:SWADHARMA LLC
Other - Org Name:TOLEDO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:AO
Authorized Official - Phone:201-867-0297
Mailing Address - Street 1:3808 BERGENLINE AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-4895
Mailing Address - Country:US
Mailing Address - Phone:201-867-0297
Mailing Address - Fax:201-867-6848
Practice Address - Street 1:3808 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-4895
Practice Address - Country:US
Practice Address - Phone:201-867-0297
Practice Address - Fax:201-867-6848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
NJ28RS004872003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2057763OtherPK
NJ6158901Medicaid
NJ6159001Medicaid
NJ6159001Medicaid