Provider Demographics
NPI:1225547995
Name:DHARMA PHARMACY LLC
Entity Type:Organization
Organization Name:DHARMA PHARMACY LLC
Other - Org Name:LIFE CARE PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DHARMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-520-2768
Mailing Address - Street 1:753 JAMES ST UNIT C4
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2108
Mailing Address - Country:US
Mailing Address - Phone:315-399-4677
Mailing Address - Fax:315-399-4678
Practice Address - Street 1:753 JAMES ST UNIT C4
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2108
Practice Address - Country:US
Practice Address - Phone:315-399-4677
Practice Address - Fax:315-399-4678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035836333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2171713OtherPK