| NPI | 1770695876 |
|---|---|
| Doing Business As | HEALTHSOURCE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | BORIS NIYAZOV President 212-794-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 025135) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-04-27 |