Healthsource Pharmacy III INC
Pharmacy, Community/Retail Pharmacy in New York, NY. Organization (NPI-2).
NPI number1023023637
StatusActive
Last updated in NPPESFeb 25, 2008
Details
- NPI
- 1023023637
- Entity type
- Organization (NPI-2)
- Legal business name
- Healthsource Pharmacy III INC
- Organization subpart
- No
- Enumeration date
- Jul 30, 2006
- Last updated
- Feb 25, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
| 333600000X | Pharmacy | 027524 | NY | |
| 3336S0011X | Pharmacy, Specialty Pharmacy | – | – |
Practice location
235 E 57th StNew York, NY 10022-2842
Phone 212-310-0111 · Fax 212-310-0144
Mailing address
235 E 57th StNew York, NY 10022-2842
Phone 212-310-0111 · Fax 212-310-0144
Authorized official
Boris Niyazov
President
2127948700
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