Provider Demographics
NPI:1508151960
Name:SARATOGA PHARMACY LLC
Entity Type:Organization
Organization Name:SARATOGA PHARMACY LLC
Other - Org Name:SARATOGA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HARESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAGAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-431-9700
Mailing Address - Street 1:12650 N BEACH ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-4243
Mailing Address - Country:US
Mailing Address - Phone:817-431-9700
Mailing Address - Fax:817-562-5700
Practice Address - Street 1:12650 N BEACH ST STE 112
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4243
Practice Address - Country:US
Practice Address - Phone:817-431-9700
Practice Address - Fax:817-562-5700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX276883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5903871OtherNCPDP PROVIDER IDENTIFICATION NUMBER