Healthcare Provider Details

I. General information

NPI: 1285563320
Provider Name (Legal Business Name): PARLAY PHARMA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 SHOTGUN RD
SUNRISE FL
33326-1934
US

IV. Provider business mailing address

755 SHOTGUN RD
SUNRISE FL
33326-1934
US

V. Phone/Fax

Practice location:
  • Phone: 800-559-5738
  • Fax:
Mailing address:
  • Phone: 800-559-5738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NGON-VINCENT VAN
Title or Position: PHARMACIST
Credential: PHARM.D.
Phone: 800-559-5738