Provider Demographics
NPI:1053010686
Name:SILVER PHARMA LLC
Entity type:Organization
Organization Name:SILVER PHARMA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DLAVAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ATHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-688-4849
Mailing Address - Street 1:4056 QUAKERBRIDGE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4779
Mailing Address - Country:US
Mailing Address - Phone:908-688-4849
Mailing Address - Fax:908-952-2009
Practice Address - Street 1:4056 QUAKERBRIDGE RD STE 107
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4779
Practice Address - Country:US
Practice Address - Phone:908-688-4849
Practice Address - Fax:908-952-2009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0682896Medicaid