Healthcare Provider Details

I. General information

NPI: 1003777335
Provider Name (Legal Business Name): CAPITAL DISTRICT PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1182 TROY SCHENECTADY RD STE 201A
LATHAM NY
12110-1000
US

IV. Provider business mailing address

1182 TROY SCHENECTADY RD STE 201A
LATHAM NY
12110-1000
US

V. Phone/Fax

Practice location:
  • Phone: 518-258-1068
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. TARIQ SERAJ
Title or Position: SUPERVISING PHARMACIST
Credential: PHARM.D
Phone: 518-258-1068