Organization Active NPI

Plaza Enterprises LTD

  • Pharmacist
  • Atlanta, GA
National Provider Identifier
1366432411
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
008238 Issued in GA
Legal business name
PLAZA ENTERPRISES LTD
Practice address
1634 Jonesboro Rd SE
Atlanta, GA 30315-5260
Phone
(404) 627-5745
Fax
(404) 935-9427
NPI assigned
Oct 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rosemary Ofume, RPH
Title
Chief Pharmacist/Ceo
Phone
(404) 627-5745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 008238 GA Primary

Addresses

Primary practice location

1634 Jonesboro Rd SE
Atlanta, GA 30315-5260

Mailing address

1634 Jonesboro Rd SE
Atlanta, GA 30315-5260
Phone (404) 627-5745

Other identifiers 1

IdentifierTypeStateIssuer
00788598MedicaidGA

Other names 1

  • MEDICINE CENTER PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

1634 Jonesboro Rd SE
Atlanta, GA 30315
Phone (404) 627-5745

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366432411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 JONESBORO RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303155260",
            "telephone_number": "404-627-5745",
            "fax_number": "404-935-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 JONESBORO RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303155260",
            "telephone_number": "404-627-5745",
            "fax_number": "404-935-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA ENTERPRISES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OFUME",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "CHIEF PHARMACIST/CEO",
        "authorized_official_telephone_number": "404-627-5745",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "008238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00788598",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.