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Organization

MAIN SOURCE PHARMACY INC

Active
Other names
MAIN SOURCE PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
SVETLANA NIYAZOVA (OWNER, RPH, AO)
(631) 760-1114
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Enumeration date
02/29/2024
Last updated
02/29/2024
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