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General NPI Number Information
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NPI Number | 1508151960
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Entity Type | Organization
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Legal Business Name | SARATOGA PHARMACY LLC
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 12650 N BEACH ST STE 112
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City | FORT WORTH
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State | TX
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Zip | 76244-4243
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Country | US
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Telephone | 817-431-9700
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Fax | 817-562-5700
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Provider Business Mailing Address
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Address Line | 12650 N BEACH ST SUITE 112
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City | FORT WORTH
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State | TX
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Zip | 76244-4243
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Country | US
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Telephone | 817-431-9700
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Fax | 817-562-5700
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | HARESH BHAGAT
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Credential |
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Telephone | 817-431-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 27688
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License Number State | TX
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