MEDICARE: PLAZA DRUGS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	4037	NM

General Provider Information

NPI Number	:	1245392851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAZA DRUGS, INC

Provider Business Mailing Address
First Line	:	178 BRIDGE ST
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-3427
Country	:	US
Telephone Number	:	505-425-5221
Fax Number	:	505-425-5222

Provider Business Practice Location Address
First Line	:	178 BRIDGE STREET
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-3427
Country	:	US
Telephone Number	:	505-425-5221
Fax Number	:	505-425-5222

Authorized Official
Title or Position	:	OWNER, PHARMACIST
Name	:	MR. ELOY E ARAGON SR.
Credential	:	RPH
Telephone Number	:	505-425-5221

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	08/22/2020

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Directions to “PLAZA DRUGS, INC ” Practice Location

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