Provider Demographics
NPI:1528647930
Name:DAKSHA SAIRAM LLC
Entity type:Organization
Organization Name:DAKSHA SAIRAM LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SWATHI
Authorized Official - Middle Name:
Authorized Official - Last Name:PINNAMANENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-888-0099
Mailing Address - Street 1:10 BETH CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1418
Mailing Address - Country:US
Mailing Address - Phone:908-888-0099
Mailing Address - Fax:
Practice Address - Street 1:2025 OLD TRENTON RD STE 4
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-2412
Practice Address - Country:US
Practice Address - Phone:609-426-0441
Practice Address - Fax:833-696-3979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH32821OtherFLORIDA LICENSE
3157991OtherNCPDP
NJ28RS00699500OtherNJ BOARD OF PHARMACY LICENSE PERMIT
FLPH32821OtherFLORIDA PHARMACY LICENSE
OHPHN11569OtherRHODE ISLAND PHARMACY OUT OF STATE LICENSE
OH240000081OtherOHIO OUT OF STATE PHARMACY LICENSE
PANP001203OtherPENNSYLVANIA PHARMACY OUT OF STATE LICENSE
PANP001203OtherPENNSYLVANIA PHARMACY OUT OF STATE LICENSE