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Organization
GREAT NECK RX INC.
Active
Organization
GREAT NECK RX INC.
Active
Other names
Pillsource Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BORIS MAKSUMOV (OWNER)
(954) 736-6957
Entity
Organization
Contact information
Practice address
140A MIDDLE NECK RD, GREAT NECK, NY 11021-1232
(516) 304-5648
Mailing address
140A MIDDLE NECK RD, GREAT NECK, NY 11021-1232
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
NULL
Other
Enumeration date
09/07/2023
Last updated
05/09/2024
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