Healthsource Pharmacy

LBN: Healthsource Pharmacy Iv, Llc
Healthsource Pharmacy is an health care organization with primary practice located at 750 Columbus Ave , New York NY 10025-6464. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Healthsource Pharmacy Iv, Llc can be contacted via phone (212) 932-0200, or through Niyazov, Boris via phone (917) 482-1154.

Contact Information

Primary practice address
750 Columbus Ave New York NY 10025-6464
Fax: (212) 932-0202
Website:
Authorized official contact:
Name: Niyazov, Boris

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 035496 New York
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1053841312
LBN Legal business name Healthsource Pharmacy Iv, Llc
DBA Doing business as Healthsource Pharmacy
Authorized official Niyazov, Boris
Entity Organization
Organization subpart 1 No
Enumeration date Jun 19th, 2017
Last updated Jun 19th, 2017 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053841312 NPPES
Other 2169943 PK

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