Active NPI
Plaza Pharmacy, Inc
- Durable Medical Equipment & Medical Supplies
- Coral Springs, FL
National Provider Identifier
1861408338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 1313348
- Legal business name
- PLAZA PHARMACY, INC
- Practice address
- 4399 NW 124TH Ave
Coral Springs, FL 33065-7634 - Phone
- (877) 770-4422
- Fax
- (954) 752-8805
- NPI assigned
- Aug 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gianpaolo Ciancimino
- Title
- Owner
- Phone
- (877) 770-4422
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 1313348 | FL | Primary |
| Community/Retail Pharmacy | 3336C0003X | PH26083 | FL |
Addresses
Primary practice location
4399 NW 124TH Ave
Coral Springs, FL 33065-7634
Mailing address
4399 NW 124TH Ave
Coral Springs, FL 33065-7634
Phone (877) 770-4422
Other identifiers 46
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861408338 | Medicaid | MO | |
| 184810741 | Medicaid | AR | |
| 1861408338 | Medicaid | SC | |
| 1861408338 | Medicaid | WA | |
| 1861408338 | Medicaid | WI | |
| 65836073 | Medicaid | CO | |
| DME16508 | Other | ID | IDAHO STATE BOARD OF PHARMACY |
| 003108720A | Medicaid | GA | |
| 1861408338 | Medicaid | DE | |
| 1861408338 | Medicaid | HI | |
| 1861408338 | Medicaid | MN | |
| 1861408338 | Medicaid | NV | |
| 3118629 | Medicaid | OH | |
| MG01127 | Other | AR | ARKANSAS STATE DME LICENSE |
| 1861408338 | Medicaid | ME | |
| 1861408338 | Medicaid | MT | |
| 1861408338 | Medicaid | WY | |
| 55753 | Medicaid | ND | |
| 7100138990 | Medicaid | KY | |
| 7470001 | Medicaid | RI | |
| P013538 | Other | AZ | ARIZONA STATE BOARD OF PHARMACY |
| 1861408338 | Medicaid | IA | |
| 1861408338 | Medicaid | MI | |
| 2009539 | Medicaid | CA | |
| 2134639 | Medicaid | LA | |
| 569954 | Medicaid | AZ | |
| 1018685 | Medicaid | VT | |
| 122917 | Medicaid | AL | |
| 1521687 | Medicaid | TN | |
| 1861408338 | Medicaid | NM | |
| 1861408338 | Medicaid | SD | |
| 1861408338 | Medicaid | VA | |
| 201015170A | Medicaid | IN | |
| 420474300 | Medicaid | MD | |
| MP00639 | Other | NV | NEVADA STATE BOARD OF PHARMACY |
| 200698380A | Medicaid | KS | |
| 52668 | Other | CA | DEPARTMENT OF PUBLIC HEALTH , FOOD AND DRUG BRANCH |
| CSW.0002763 | Other | CT | STATE OF CONNECTICUT |
| NPC-0003635 | Other | OR | OREGON BOARD OF PHARMACY |
| 10025906100 | Medicaid | NE | |
| 1861408338 | Medicaid | ID | |
| 1861408338 | Medicaid | NY | |
| 1861408338 | Medicaid | UT | |
| 3810019574 | Medicaid | WV | |
| 603096940 | Other | WA | STATE OF WASHINGTON |
| 7859530-1708 | Other | UT | STATE OF UTAH DEPARTMENT OF COMMERCE |
Other names 1
- Plaza Healthcare Solutions
National Provider Directory
National Provider DirectoryLocations
4399 NW 124th Ave
Coral Springs, FL 33065
Phone (877) 770-4422
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1393372800000",
"number": "1861408338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4399 NW 124TH AVE",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330657634",
"telephone_number": "877-770-4422",
"fax_number": "954-728-5505"
},
{
"country_code": "US",
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"city": "CORAL SPRINGS",
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"postal_code": "330657634",
"telephone_number": "877-770-4422",
"fax_number": "954-752-8805"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLAZA PHARMACY, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-01",
"last_updated": "2014-02-26",
"status": "A",
"authorized_official_last_name": "CIANCIMINO",
"authorized_official_first_name": "GIANPAOLO",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "877-770-4422",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "FL",
"license": "1313348",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
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"license": "PH26083",
"primary": false
}
],
"identifiers": [
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{
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"state": "MN"
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{
"code": "01",
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"identifier": "MG01127",
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{
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{
"code": "05",
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{
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{
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{
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"state": "RI"
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{
"code": "01",
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"issuer": "ARIZONA STATE BOARD OF PHARMACY",
"identifier": "P013538",
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{
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{
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{
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"identifier": "2134639",
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{
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{
"code": "05",
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{
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{
"code": "05",
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{
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{
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{
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{
"code": "01",
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{
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"state": "ID"
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{
"code": "05",
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"issuer": null,
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{
"code": "01",
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"identifier": "603096940",
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},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF UTAH DEPARTMENT OF COMMERCE",
"identifier": "7859530-1708",
"state": "UT"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Plaza Healthcare Solutions",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.