Plaza Drug of London LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

P07655 Issued in KY

Legal business name

PLAZA DRUG OF LONDON LLC

Doing business as

Plaza Drug of London

Practice address

731 N Laurel Rd
London, KY 40741-6025

Phone

(606) 657-5245

Fax

(606) 657-5382

NPI assigned

Sep 26, 2016

Last updated

Feb 28, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mike Sizemore

Title

Owner/President

Phone

(606) 657-5245

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Plaza Drug of London Doing business as

Tax ID family

Plaza Drug of London2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Plaza Drug of London LLC

  dba Plaza Drug of London

  • Community/Retail Pharmacy
  • London, KY
  • NPI 1770904989
  NPD tax ID

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1720537251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 202",
            "city": "PITTSBURG",
            "state": "KY",
            "postal_code": "407550202",
            "telephone_number": "606-657-5245",
            "fax_number": "606-657-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 N LAUREL RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407416025",
            "telephone_number": "606-657-5245",
            "fax_number": "606-657-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA DRUG OF LONDON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-26",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "SIZEMORE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "606-657-5245"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "KY",
            "license": "P07655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164322",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100281580",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100430090",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plaza Drug of London",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in London, KY
• Providers in London, KY by specialty
• Long Term Care Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.