Organization · NPI-2

All-Source Corp

Pharmacy, Community/Retail Pharmacy · Rego Park, NY

NPI number1013272095

StatusActive

Last updated in NPPESSep 19, 2025

Details

NPI: 1013272095
Entity type: Organization (NPI-2)
Legal business name: All-Source Corp
Organization subpart: No
Enumeration date: Jul 6, 2012
Last updated: Sep 19, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
3336C0003X	Pharmacy, Community/Retail Pharmacy	031371	NY	Yes
333600000X	Pharmacy	–	–
332000000X	MilitaryU.S. Coast Guard Pharmacy	–	–
3336C0004X	Pharmacy, Compounding Pharmacy	–	–
3336M0002X	Pharmacy, Mail Order Pharmacy	–	–
3336M0003X	Pharmacy, Managed Care Organization Pharmacy	–	–
3336S0011X	Pharmacy, Specialty Pharmacy	–	–
332100000X	Department of Veterans Affairs (VA) Pharmacy	–	–
332B00000X	Durable Medical Equipment & Medical Supplies	–	–
332BP3500X	Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition	–	–

Other names

All-Source Pharmacy & Surgical (Doing Business As)

Practice location

9109 63rd Dr
Rego Park, NY 11374-3849

Phone 718-255-6100 · Fax 718-255-6104

Mailing address

9109 63rd Dr
Rego Park, NY 11374-3849

Phone 718-255-6100 · Fax 718-255-6104

Authorized official

Peter Nyazov
President
7182556100

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