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General NPI Number Information
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NPI Number | 1366432411
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Entity Type | Organization
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Legal Business Name | PLAZA ENTERPRISES LTD
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1634 JONESBORO RD SE
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City | ATLANTA
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State | GA
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Zip | 30315-5260
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Country | US
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Telephone | 404-627-5745
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Fax | 404-935-9427
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Provider Business Mailing Address
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Address Line | 1634 JONESBORO RD SE
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City | ATLANTA
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State | GA
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Zip | 30315-5260
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Country | US
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Telephone | 404-627-5745
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Fax | 404-935-9427
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Authorized Official
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Title or Position | CHIEF PHARMACIST/CEO
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Name | ROSEMARY OFUME
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Credential | RPH
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Telephone | 404-627-5745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 008238
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License Number State | GA
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