Provider Demographics
NPI:1558698936
Name:SATYAM PHARMACY INC
Entity Type:Organization
Organization Name:SATYAM PHARMACY INC
Other - Org Name:MOUNT ARLINGTON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-601-3617
Mailing Address - Street 1:181 HOWARD BLVD
Mailing Address - Street 2:UNIT F-1
Mailing Address - City:MOUNT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856-2314
Mailing Address - Country:US
Mailing Address - Phone:973-601-3617
Mailing Address - Fax:973-601-3618
Practice Address - Street 1:181 HOWARD BLVD UNIT F-1
Practice Address - Street 2:
Practice Address - City:MOUNT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856-2314
Practice Address - Country:US
Practice Address - Phone:973-601-3617
Practice Address - Fax:973-601-3618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS006976003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0220051Medicaid
2122653OtherPK
NJ0220051Medicaid