| NPI | 1417512500 |
|---|---|
| Doing Business As | ALL-SOURCE PHARMACY & SURGICAL |
| Entity Type | Organization |
| Authorized Contact | IRINA NIYAZOV Rph 718-255-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2019-05-05 |
| Last Update Date | 2019-05-05 |