Organization · NPI-2

Health Source Plus Pharmacy, LLC.

Pharmacy, Community/Retail Pharmacy · Kew Gardens, NY

NPI number1710117908

StatusActive

Last updated in NPPESMar 29, 2017

Details

NPI: 1710117908
Entity type: Organization (NPI-2)
Legal business name: Health Source Plus Pharmacy, LLC.
Organization subpart: No
Enumeration date: Jul 22, 2009
Last updated: Mar 29, 2017

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
3336C0003X	Pharmacy, Community/Retail Pharmacy	029701	NY	Yes
3336L0003X	Pharmacy, Long Term Care Pharmacy	029701	NY
3336S0011X	Pharmacy, Specialty Pharmacy	029701	NY

Practice location

11807 Metropolitan Ave
Kew Gardens, NY 11415-2020

Phone 718-849-6700 · Fax 718-849-1659

Mailing address

11807 Metropolitan Ave
Kew Gardens, NY 11415-2020

Phone 718-849-6700 · Fax 718-849-1659

Authorized official

Emma Kalontar
Pharmacist
7188496700

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