Provider Demographics
NPI:1295030278
Name:SAI SWAMI III LLC
Entity Type:Organization
Organization Name:SAI SWAMI III LLC
Other - Org Name:SHAYONA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DIPAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-907-0074
Mailing Address - Street 1:38660 SUSSEX HWY
Mailing Address - Street 2:UNIT 10
Mailing Address - City:DELMAR
Mailing Address - State:DE
Mailing Address - Zip Code:19940-3529
Mailing Address - Country:US
Mailing Address - Phone:302-907-0074
Mailing Address - Fax:302-907-0121
Practice Address - Street 1:38660 SUSSEX HWY
Practice Address - Street 2:UNIT 10
Practice Address - City:DELMAR
Practice Address - State:DE
Practice Address - Zip Code:19940-3529
Practice Address - Country:US
Practice Address - Phone:302-907-0074
Practice Address - Fax:302-907-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPENDING3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
7122150001Medicare NSC