=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740265511
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAS PHARMA INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2005
-----------------------------------------------------
Last Update Date | 02/20/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1108 LIBERTY AVE
-----------------------------------------------------
City | HILLSIDE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07205-2103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-354-3169
-----------------------------------------------------
Fax | 908-354-4167
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1108 LIBERTY AVE
-----------------------------------------------------
City | HILLSIDE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07205-2103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-354-3169
-----------------------------------------------------
Fax | 908-354-4167
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | SHIL PATEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 908-354-3169
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336S0011X
-----------------------------------------------------
Taxonomy Name | Specialty Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 28RS00707800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------