Organization
PLYMOUTH PARK PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN SCOTT PISKADLO (PRESIDENT)
(201) 797-0006
Entity
Organization
Contact information
Practice address
11 12 SADDLE RIVER RD, FAIR LAWN, NJ 07410-5786
(201) 797-0006
(201) 797-0007
Mailing address
11 12 SADDLE RIVER RD, FAIR LAWN, NJ 07410-5786
(201) 797-0006
(201) 797-0007
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS001207900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0698628
—
NJ
01
—
2055710
PK
—
Enumeration date
06/19/2006
Last updated
10/13/2019
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