Provider Demographics
NPI:1639706625
Name:SUSHRUT HEALTHCARE, LLC
Entity Type:Organization
Organization Name:SUSHRUT HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAITALI
Authorized Official - Middle Name:
Authorized Official - Last Name:DESHPANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-289-7817
Mailing Address - Street 1:809 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2708
Mailing Address - Country:US
Mailing Address - Phone:908-353-6900
Mailing Address - Fax:908-353-5807
Practice Address - Street 1:809 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2708
Practice Address - Country:US
Practice Address - Phone:908-353-6900
Practice Address - Fax:908-353-5807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy