Organization
PLAZA PROFESSIONAL PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD M SHIBLEY JR. RPH, MBA (DIRECTOR OF PHARMACY)
(804) 264-1319
Entity
Organization
Contact information
Practice address
1717 BELLEVUE AVE, RICHMOND, VA 23227-3961
(804) 264-1319
(804) 264-2133
Mailing address
1717 BELLEVUE AVE, RICHMOND, VA 23227-3961
(804) 264-1319
(804) 264-2133
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201001356
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008510610
—
VA
Enumeration date
12/08/2006
Last updated
10/31/2013
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