# PLYMOUTH PARK PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023053469
- **Authorized official:** BRYAN SCOTT PISKADLO (PRESIDENT)
- **Authorized official phone:** (201) 797-0006

## Contact information

- **Practice address:** 11 12 SADDLE RIVER RD, FAIR LAWN, NJ 07410-5786
- **Practice address phone:** (201) 797-0006
- **Practice address fax:** (201) 797-0007
- **Mailing address:** 11 12 SADDLE RIVER RD, FAIR LAWN, NJ 07410-5786
- **Mailing address phone:** (201) 797-0006
- **Mailing address fax:** (201) 797-0007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS001207900 | NJ | Yes |

## Other

- **Enumeration date:** 06/19/2006
- **Last updated:** 10/13/2019