Provider Demographics
NPI:1578609186
Name:AMAR NIYA PHARMACY, INC
Entity Type:Organization
Organization Name:AMAR NIYA PHARMACY, INC
Other - Org Name:AMAR PHARMACY HE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SACHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-518-4752
Mailing Address - Street 1:2500 W HIGGINS RD STE 450
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-7208
Mailing Address - Country:US
Mailing Address - Phone:847-944-8261
Mailing Address - Fax:847-944-8262
Practice Address - Street 1:2500 W HIGGINS RD STE 450
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7208
Practice Address - Country:US
Practice Address - Phone:847-944-8261
Practice Address - Fax:847-944-8262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
IL054.0145663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2020981OtherPK
IL364418968001Medicaid
4590720001Medicare NSC
1474307OtherOTHER ID NUMBER