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Export Provider Record NPI 1023053469
Plymouth Park Pharmacy Inc
Organization Subpart: NO
Active
NPI Number1023053469
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1023053469
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-06-19
Last Updated2019-10-13
Authorized OfficialBryan Piskadlo
President
Phone: 2017970006
Mailing Address11 12 Saddle River Rd
Fair Lawn, NJ 07410-5786
United States
Phone: (201) 797-0006 | Fax: (201) 797-0007
📍 View Map
Primary Practice Address11 12 Saddle River Rd
Fair Lawn, NJ 07410-5786
United States
Phone: (201) 797-0006 | Fax: (201) 797-0007
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNJ0698628
Other (non-Medicare)2055710PK
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No333600000X – Pharmacy
Yes3336C0003X – Pharmacy, Community/Retail PharmacyNJ28RS001207900
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About NPI 1023053469

Plymouth Park Pharmacy Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1023053469. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Fair Lawn, NJ. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-06-19. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1023053469?

NPI 1023053469 belongs to Plymouth Park Pharmacy Inc, a Pharmacy, Community/Retail Pharmacy in Fair Lawn, NJ. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1023053469 active?

The current status of NPI 1023053469 in the NPPES registry is Active. The record was last updated on 2019-10-13.

What specialty is NPI 1023053469?

NPI 1023053469 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1023053469?

You can verify NPI 1023053469 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1023053469?

The primary practice address on file for NPI 1023053469 is 11 12 Saddle River Rd, Fair Lawn, NJ 07410-5786. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1023053469 issued?

NPI 1023053469 was first issued (enumerated) on 2006-06-19. The NPPES record was last updated on 2019-10-13.

Practice Location Map

Plymouth Park Pharmacy Inc is located at 11 12 Saddle River Rd, Fair Lawn, NJ. Use the map below to find directions or verify the practice location.

📍 11 12 Saddle River Rd, Fair Lawn, NJ 07410-5786  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Plymouth Park Pharmacy Inc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1023053469. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Community/Retail Pharmacy28RS001207900NJ
Data Verified from CMS NPPES Last synced: 2026-06-08 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162