# MAIN SOURCE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MAIN SOURCE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861259434
- **Authorized official:** SVETLANA NIYAZOVA (OWNER, RPH, AO)
- **Authorized official phone:** (631) 760-1114

## Contact information

- **Practice address:** 347B MAIN ST, HUNTINGTON, NY 11743-6914
- **Practice address phone:** (631) 760-1114
- **Practice address fax:** (631) 760-1035
- **Mailing address:** 347B MAIN ST, HUNTINGTON, NY 11743-6914
- **Mailing address phone:** (631) 760-1114
- **Mailing address fax:** (631) 760-1035

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/29/2024
- **Last updated:** 02/29/2024