MEDISOURCE PHARMACY INC (NPI# 1215197991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215197991 |
| Entity Type | Organization |
| Organization Name | MEDISOURCE PHARMACY INC |
| Other Organization Name | MEDISOURCE PHARMACY INC |
| Practice Address |
720 Old Country Rd Plainview NY 11803-4929 |
| Practice Telephone | 5166050080 |
| Practice Fax Number | 5166050077 |
| Mailing Telephone | 5166050080 |
| Mailing Fax Number | 5166050077 |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2015-02-20 |
| Authorized Official Name | DAVID KHANTSES (MEMBER) |
| Authorized Official Telephone | 5166050080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
028939 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2070643 | 01 | |
| NY | 3016644 | 05 |
| Other Name | Type Code |
|---|---|
| MEDISOURCE PHARMACY INC | Doing Business As Name - Organization |
| Street Address |
720 OLD COUNTRY RD |
| City | PLAINVIEW |
| State | NY |
| Zip Code | 11803-4929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750541439 | Elina Rozenfeld | Pharmacist | 720 Old Country Rd, Plainview, NY 11803-4929 | 2008-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730797010 | Lynn Marie Viscusi | Chiropractor | 1163 Old Country Road, Plainview, NY 11803 | 2020-07-22 |
| 1649798240 | Audrey Demas | Early Intervention Provider Agency | 255 Executive Drive Suite Ll 105/108, Plainview, NY 11803 | 2017-09-03 |
| 1649798521 | Danielle J Walowitz | Specialist | 19 Pearl Drive, Plainview, NY 11803 | 2017-08-31 |
| 1437676178 | Jaclyn Heather Rosenblum | Speech-Language Pathologist | 2 Edgewood Gate, Plainview, NY 11803 | 2017-08-24 |
| 1548784531 | Giselle Cortez | Registered Nurse | 53 Belmont Avenue, Plainview, NY 11803 | 2017-08-01 |
| 1528500808 | Michelle Tamarez | Nurse Practitioner | 131 E. Ames Ct, Plainview, NEW YORK 11803 | 2016-11-17 |
| 1649656646 | Marjorie Elise Tirsun | Specialist | 10 Crestwood Drive, Plainview, NY 11803 | 2015-08-03 |
| 1295110872 | Elizabeth Scisci | Dentist | 146a Manetto Hill Rd Ste 100, Plainview, NY 11803 | 2015-07-24 |
| 1114332905 | Alberto Roman Cabezas | Internal Medicine | Sanchez, Curridabat, SAN JOSE 11803 | 2014-06-30 |
| 1568883148 | Chiropractic Doc Spine, PC | Chiropractor | 42 Ruby Ln, Plainview, NY 11803 | 2013-12-26 |
| Find all providers in zip 11803 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134772452 | Variety Pharmacy LLC | Pharmacy | 100 Manetto Hill Rd Ste 104, Plainview, NY 11803-1311 | 2019-07-17 |
| 1356609358 | Agp Pharmacy LLC | Pharmacy | 3200 Olton Rd, B, Plainview, TX 79072-6653 | 2012-04-26 |
| 1043386964 | Micrognostics, Inc. | Pharmacy | 102 West Main St, Plainview, AR 72857 | 2006-11-24 |
| 1215035860 | Cvs Albany LLC | Pharmacy | 1026 Old Country Rd Morton Village Plz, Plainview, NY 11803 | 2006-09-20 |
| 1184722720 | Cvs Albany LLC | Pharmacy | 419 South Oyster Bay Rd Woodbury Plz Sc, Plainview, NY 11803 | 2006-09-20 |
| 1801037353 | Mcbe Company | Pharmacy | 435 W Broadway, Plainview, MN 55964-1257 | 2009-03-13 |
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|---|---|---|---|---|
| 1891396388 | Sharx Corp | Pharmacy | 4301 48th Ave, Woodside, NY 11377-6241 | 2020-11-03 |
| 1841890878 | Corner Pharmacy Myrtle | Pharmacy | 680 Myrtle Ave, Brooklyn, NY 11205-4119 | 2020-10-28 |
| 1124627302 | Elite Pharmacy Inc. | Pharmacy | 614a Grand St, Brooklyn, NY 11211-4802 | 2020-10-20 |
| 1073111951 | Pharmacy On Bay Street Inc. | Pharmacy | 1209 Bay St, Staten Island, NY 10305-3121 | 2020-10-13 |
| 1760080741 | Carol Pharmacy LLC | Pharmacy | 4230 Broadway, New York, NY 10033-3746 | 2020-10-13 |
| 1528666443 | Mvp Pharmacy Inc | Pharmacy | 920 Wheeler Rd Ste 920, Hauppauge, NY 11788-2900 | 2020-10-13 |
| 1477151512 | 101 Rx Pharmacy Inc | Pharmacy | 101 Rx Pharmacy Inc, 9718 101st Ave, Ozone Park, NY 11416 | 2020-10-12 |
| 1043818289 | Xuwei Lin | Pharmacy | 8218 14th Ave, Brooklyn, NY 11228-3114 | 2020-10-10 |
| 1043817463 | Angella Samson | Pharmacy | 1346 Granville Payne Ave, Brooklyn, NY 11239-2103 | 2020-10-08 |
| 1366059792 | Community Healthcare Network Inc. | Pharmacy | 999 Blake Ave Fl 1, Brooklyn, NY 11208-3535 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.