1306620521 NPI number — DANTE RICHARD SAWYER PHARMD, RPH

Table of content: DANTE RICHARD SAWYER PHARMD, RPH (NPI 1306620521)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306620521 NPI number — DANTE RICHARD SAWYER PHARMD, RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAWYER
Provider First Name:
DANTE
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD, RPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306620521
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 ORANGEWOOD LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURLINGTON TOWNSHIP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08016-5100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-712-2146
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3003 ROUTE 130
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DELRAN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08075-2412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-764-5624
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/21/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  28RI04321100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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