| NPI | 1679318125 |
|---|---|
| Doing Business As | HEALTHSOURCE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | BORIS NIYAZOV President 212-794-8700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-06-26 |