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
—
—
Other
Enumeration date
09/07/2023
Last updated
05/09/2024
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