Provider Demographics
NPI:1437248069
Name:SANRAJ INC.
Entity Type:Organization
Organization Name:SANRAJ INC.
Other - Org Name:ISELIN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:HIRAL
Authorized Official - Middle Name:V
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:732-283-1111
Mailing Address - Street 1:1186 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2012
Mailing Address - Country:US
Mailing Address - Phone:732-283-1111
Mailing Address - Fax:732-283-9633
Practice Address - Street 1:1186 GREEN ST
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2012
Practice Address - Country:US
Practice Address - Phone:732-283-1111
Practice Address - Fax:732-283-9633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00514900332B00000X
NJ28RI02567900333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6641008Medicaid
NJ6641016Medicaid
1316100001Medicare NSC