Provider Demographics
NPI:1245392851
Name:PLAZA DRUGS, INC
Entity Type:Organization
Organization Name:PLAZA DRUGS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ELOY
Authorized Official - Middle Name:E
Authorized Official - Last Name:ARAGON
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:505-425-5221
Mailing Address - Street 1:178 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-3427
Mailing Address - Country:US
Mailing Address - Phone:505-425-5221
Mailing Address - Fax:505-425-5222
Practice Address - Street 1:178 BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-3427
Practice Address - Country:US
Practice Address - Phone:505-425-5221
Practice Address - Fax:505-425-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM0264320001Medicare ID - Type Unspecified