Plaza LTC Pharmacy

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

0201003958 Issued in VA

Legal business name

PLAZA LTC PHARMACY

Practice address

1717 Bellevue Ave Apt A605
Richmond, VA 23227-3936

Phone

(804) 864-0276

Fax

(804) 864-0275

NPI assigned

Dec 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Edward M Shibley Jr., RPH, MBA

Title

Director of Pharmacy

Phone

(804) 864-0276

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1336208727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 BELLEVUE AVE APT A605",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273936",
            "telephone_number": "804-864-0276",
            "fax_number": "804-864-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 BELLEVUE AVE APT A605",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273936",
            "telephone_number": "804-864-0276",
            "fax_number": "804-864-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA LTC PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "SHIBLEY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "804-864-0276",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH, MBA"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "VA",
            "license": "0201003958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Long Term Care Pharmacy in Richmond, VA
• Providers in Richmond, VA by specialty
• Long Term Care Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.