Organization
NORTHRIDGE PLAZA PHARMACY INC.
Active
Organization
NORTHRIDGE PLAZA PHARMACY INC.
Active
Other names
SMP Pharmacy Solutions #4
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS MANUEL GOMEZ (QUALITY & PROJECT MANAGER)
(305) 740-9720
Entity
Organization
Contact information
Practice address
18546 ROSCOE BLVD., #102, NORTHRIDGE, CA 91324
(818) 998-8700
(818) 998-8730
Mailing address
7425 SW 42ND ST, MIAMI, FL 33155-4402
(305) 740-9696
(818) 998-8730
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2066993
PK
—
05
—
PHA393410
—
CA
Enumeration date
11/02/2007
Last updated
05/11/2020
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