Provider Demographics
NPI:1437432234
Name:SARHADDI PHARMACEUTICAL INC
Entity Type:Organization
Organization Name:SARHADDI PHARMACEUTICAL INC
Other - Org Name:GATEWAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SARHADDI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:510-604-8287
Mailing Address - Street 1:1330 GATEWAY BLVD
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6915
Mailing Address - Country:US
Mailing Address - Phone:707-442-0500
Mailing Address - Fax:707-442-0555
Practice Address - Street 1:1330 GATEWAY BLVD STE B2
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6915
Practice Address - Country:US
Practice Address - Phone:707-442-0500
Practice Address - Fax:707-442-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50683333600000X, 333600000X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2132037OtherPK
CA6671240001Medicare NSC