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General NPI Number Information
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NPI Number | 1861408338
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Entity Type | Organization
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Legal Business Name | PLAZA PHARMACY, INC
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 02/26/2014
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Provider Practice Location Address
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Address Line | 4399 NW 124TH AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-7634
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Country | US
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Telephone | 877-770-4422
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Fax | 954-752-8805
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Provider Business Mailing Address
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Address Line | 4399 NW 124TH AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-7634
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Country | US
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Telephone | 877-770-4422
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Fax | 954-728-5505
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Authorized Official
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Title or Position | OWNER
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Name | MR. GIANPAOLO CIANCIMINO
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Credential |
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Telephone | 877-770-4422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26083
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1313348
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License Number State | FL
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