Provider Demographics
NPI:1669797858
Name:SAI RAM PHARMACY INC.
Entity type:Organization
Organization Name:SAI RAM PHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:R.PH
Authorized Official - Prefix:MR
Authorized Official - First Name:SUMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-617-6541
Mailing Address - Street 1:1575 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040
Mailing Address - Country:US
Mailing Address - Phone:516-492-3520
Mailing Address - Fax:516-492-3523
Practice Address - Street 1:1575 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2521
Practice Address - Country:US
Practice Address - Phone:516-492-3520
Practice Address - Fax:516-492-3523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03225394Medicaid
NY6393250001Medicare NSC