Organization · NPI-2

Plymouth Park Pharmacy INC

Pharmacy, Community/Retail Pharmacy · Fair Lawn, NJ

NPI number1023053469
StatusActive
Last updated in NPPESOct 13, 2019

Details

NPI
1023053469
Entity type
Organization (NPI-2)
Legal business name
Plymouth Park Pharmacy INC
Organization subpart
No
Enumeration date
Jun 19, 2006
Last updated
Oct 13, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy28RS001207900NJYes
333600000X Pharmacy––

Practice location

11 12 Saddle River Rd
Fair Lawn, NJ 07410-5786

Phone 201-797-0006 · Fax 201-797-0007

Mailing address

11 12 Saddle River Rd
Fair Lawn, NJ 07410-5786

Phone 201-797-0006 · Fax 201-797-0007

Authorized official

Bryan Scott Piskadlo
President
2017970006

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