NPIMap

Organization Active NPI

Park Plaza Pharmacy, Inc.

  • Pharmacy
  • Matawan, NJ
National Provider Identifier
1427566769
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
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
Jan 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Joseph P Tarallo, RPHNPI 1447255344
Title
President
Phone
(732) 290-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

343 Highway 34
Matawan, NJ 07747-9514

Mailing address

6 Briarwood Dr
Matawan, NJ 07747-3505
Phone (732) 290-9111

Other identifiers 1

IdentifierTypeStateIssuer
4373502MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1427566769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BRIARWOOD DR",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473505",
            "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": "2018-01-22",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "TARALLO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-290-9111",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4373502",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matawan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.