Plaza Professional Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201001356 Issued in VA

Legal business name

PLAZA PROFESSIONAL PHARMACY INC

Practice address

1717 Bellevue Ave
Richmond, VA 23227-3961

Phone

(804) 264-1319

Fax

(804) 264-2133

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) 264-1319

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383177600000",
    "number": "1487713863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 BELLEVUE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273961",
            "telephone_number": "804-264-1319",
            "fax_number": "804-264-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 BELLEVUE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273961",
            "telephone_number": "804-264-1319",
            "fax_number": "804-264-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA PROFESSIONAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2013-10-31",
        "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": "804-264-1319",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH, MBA"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201001356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008510610",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Richmond, VA
• Providers in Richmond, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.