PLYMOUTH PARK PHARMACY INC (NPI# 1023053469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023053469 |
| Entity Type | Organization |
| Organization Name | PLYMOUTH PARK PHARMACY INC |
| Practice Address |
11 12 Saddle River Rd Fair Lawn NJ 07410-5786 |
| Practice Telephone | 2017970006 |
| Practice Fax Number | 2017970007 |
| Mailing Telephone | 2017970006 |
| Mailing Fax Number | 2017970007 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2019-10-13 |
| Authorized Official Name | BRYAN SCOTT PISKADLO (PRESIDENT) |
| Authorized Official Telephone | 2017970006 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
28RS001207900 | NJ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2055710 | 01 | |
| NJ | 0698628 | 05 |
| Street Address |
11 12 SADDLE RIVER RD |
| City | FAIR LAWN |
| State | NJ |
| Zip Code | 07410-5786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669093316 | Sheila Robinson-kiss LLC | Counselor | 0-178 Tunbridge Road, Fair Lawn, NJ 07410 | 2020-05-05 |
| 1750902813 | Pine Group LLC | Point of Service | 0-39 Pine Ave, Fair Lawn, NJ 07410 | 2020-04-29 |
| 1073133153 | Maria Jidriska Myers | Nurse Practitioner | 23-00 Nj-208, Fair Lawn, NJ 07410 | 2020-04-20 |
| 1508350869 | Jill Marie Deperi | Counselor | 22-08 Route 208 South, Fair Lawn, NJ 07410 | 2018-06-20 |
| 1952895419 | Laurel Olson | Counselor | Care Plus Nj Children and Family Services, 17-07 Romaine Street, Fair Lawn, NJ 07410 | 2018-06-19 |
| 1851896583 | Janelle Frazier | Social Worker | Care Plus New Jersey, 17-07 Romaine St, Fair Lawn, NJ 07410 | 2018-03-26 |
| 1457876260 | Daniella Suric | Behavioral Analyst | 2-08 Morlot Avenue, Fair Lawn, NJ 07410 | 2017-08-14 |
| 1912453549 | Marcia Gurfield | Social Worker | 33-03 Ryan Road, Fair Lawn, NJ 07410 | 2016-09-01 |
| 1417330721 | The Arc of Bergen and Passaic Counties, Inc | Day Training, Developmentally Disabled Services | 17-03a Broadway, Fair Lawn, NJ 07410 | 2015-07-06 |
| 1275914228 | Julius Iratagotia | Occupational Therapist | 0-53 26th St, Fair Lawn, NJ 07410 | 2015-06-16 |
| Find all providers in zip 07410 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396126413 | Jiffy Scripts Rx, LLC | Pharmacy | 3110 Promenade Blvd, Fair Lawn, NJ 07410-2777 | 2015-06-15 |
| 1558593574 | Fairlawn Pharmacy Limited Liability Company | Pharmacy | 14-25 Plaza Rd, Fair Lawn, NJ 07410-3546 | 2009-08-10 |
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|---|---|---|---|---|
| 1730787938 | Bonhamtown Pharmacy LLC | Pharmacy | 2853 Woodbridge Ave, Suite 8, Edison, NJ 08837 | 2020-10-12 |
| 1881292894 | Morristown Rx LLC | Pharmacy | 95 Madison Ave Ste 110, Morristown, NJ 07960-7331 | 2020-10-12 |
| 1720686900 | Rome Rx LLC | Pharmacy | 3131 Route 38 Ste 20, Mount Laurel, NJ 08054-9764 | 2020-10-11 |
| 1255939492 | Jj Pharmacy | Pharmacy | 119 Broad Ave, Palisades Park, NJ 07650-1441 | 2020-10-10 |
| 1376150011 | Ryten Rx, LLC | Pharmacy | 458 Amboy Ave Ste 2, Woodbridge, NJ 07095-2948 | 2020-09-27 |
| 1578170569 | New Jersery Cvs Pharmacy LLC | Pharmacy | 750 Memorial Pkwy, Phillipsburg, NJ 08865-1679 | 2020-09-24 |
| 1770196693 | Dharmsutay LLC | Pharmacy | 1905 Route 88 Ste 5, Brick, NJ 08724-3156 | 2020-08-29 |
| 1598376030 | Westside Pharmacy LLC | Pharmacy | 455 West Side Ave, Jersey City, NJ 07304-1425 | 2020-08-10 |
| 1245848993 | Plaza Pharmacy Corp | Pharmacy | 84 Veronica Ave Ste A107, Somerset, NJ 08873-3529 | 2020-07-20 |
| 1285242008 | Cure Rx Pharmacy PC | Pharmacy | 600 Mule Rd Unit 2, Toms River, NJ 08757-6460 | 2020-07-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.