Provider Demographics
NPI:1902331937
Name:MARUTI RX LLC
Entity Type:Organization
Organization Name:MARUTI RX LLC
Other - Org Name:OLDEN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PADIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-981-7555
Mailing Address - Street 1:930 S OLDEN AVE
Mailing Address - Street 2:OLDEN PHARMACY
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-5160
Mailing Address - Country:US
Mailing Address - Phone:609-586-6661
Mailing Address - Fax:609-586-0988
Practice Address - Street 1:930 S OLDEN AVE
Practice Address - Street 2:OLDEN PHARMACY
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-5160
Practice Address - Country:US
Practice Address - Phone:609-586-6661
Practice Address - Fax:609-586-0988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS005054003336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4252802Medicaid