Organization
PARK PLAZA PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH P TARALLO RPH (PRESIDENT)
(732) 290-9111
Entity
Organization
Contact information
Practice address
343 HIGHWAY 34, MATAWAN, NJ 07747-9514
(732) 290-9111
(732) 441-3693
Mailing address
6 BRIARWOOD DR, MATAWAN, NJ 07747-3505
(732) 290-9111
(732) 441-3693
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4373502
—
NJ
Enumeration date
01/22/2018
Last updated
06/16/2018
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