Organization
PARK PLAZA PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VADYM DETS (OWNER)
(732) 290-9111
Entity
Organization
Contact information
Practice address
343 HIGHWAY 34, MATAWAN, NJ 07747-9514
(732) 290-9111
(732) 441-3693
Mailing address
343 HIGHWAY 34, MATAWAN, NJ 07747-9514
(732) 290-9111
(732) 441-3693
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
28RS00383600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RS00383600
PHARMACY PERMIT #
NJ
01
—
3128077
NABP #
—
05
—
4373502
—
NJ
Enumeration date
06/12/2005
Last updated
09/24/2020
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