Organization
PLAZA DRUG OF LONDON LLC
Active
Organization
PLAZA DRUG OF LONDON LLC
Active
Other names
Plaza Drug of London
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SIZEMORE (OWNER)
(606) 657-5245
Entity
Organization
Contact information
Practice address
731 N LAUREL RD, LONDON, KY 40741-6025
(606) 657-5245
(606) 657-5382
Mailing address
PO BOX 202, PITTSBURG, KY 40755-0202
(606) 657-5245
(606) 657-5382
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07655
KY
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152601
PK
—
05
—
7100281580
—
KY
05
—
7100430090
—
KY
Enumeration date
12/16/2013
Last updated
12/30/2020
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