Park Plaza Pharmacy, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

28RS00383600 Issued in NJ

Legal business name

PARK PLAZA PHARMACY, INC.

Practice address

343 Highway 34
Matawan, NJ 07747-9514

Phone

(732) 290-9111

Fax

(732) 441-3693

NPI assigned

Jun 12, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Vadym Dets

Title

Owner

Phone

(732) 290-9111

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra Ann Tarallo, R.PH.

  • Pharmacist
  • Matawan, NJ
  • NPI 1538164439
  NPD (past)

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

{
    "created_epoch": "1118534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1366446833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 HIGHWAY 34",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077479514",
            "telephone_number": "732-290-9111",
            "fax_number": "732-441-3693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 HIGHWAY 34",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077479514",
            "telephone_number": "732-290-9111",
            "fax_number": "732-441-3693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLAZA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-12",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "DETS",
        "authorized_official_first_name": "VADYM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-290-9111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "28RS00383600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT #",
            "identifier": "28RS00383600",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP #",
            "identifier": "3128077",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4373502",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Papa Ganache Project, LLC
• Parabhram LLC
• Parabhram LLC
• Danielle Parascondola
• Tejal Parikh
• Park Plaza Pharmacy, Inc.
• Heather Passarelli, MSW
• Avani Patel, BSN
• Bindiya P Patel, DPT
• Falguni Patel, MD

• Pharmacy in Matawan, NJ
• Providers in Matawan, NJ by specialty
• Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.