Healthcare Provider Details

I. General information

NPI: 1649196916
Provider Name (Legal Business Name): SOUTH PLAINFIELD PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 HAMILTON BLVD STE 1A
SOUTH PLAINFIELD NJ
07080-2031
US

IV. Provider business mailing address

1110 HAMILTON BLVD STE 1A
SOUTH PLAINFIELD NJ
07080-2031
US

V. Phone/Fax

Practice location:
  • Phone: 908-256-3232
  • Fax: 908-756-3111
Mailing address:
  • Phone: 908-256-3232
  • Fax: 908-756-3111

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: MOHAMED SEOUD
Title or Position: PRESIDENT
Credential:
Phone: 908-256-3232