Healthsource Pharmacy III Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

HEALTHSOURCE PHARMACY III INC

Practice address

235 E 57TH St
New York, NY 10022-2842

Phone

(212) 310-0111

Fax

(212) 310-0144

NPI assigned

Jul 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Boris Niyazov, R.PH, MBA

Title

President

Phone

(212) 794-8700

Specialties & licenses 3

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1023023637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E 57TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222842",
            "telephone_number": "212-310-0111",
            "fax_number": "212-310-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E 57TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222842",
            "telephone_number": "212-310-0111",
            "fax_number": "212-310-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE PHARMACY III INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "NIYAZOV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-794-8700",
        "authorized_official_credential": "R.PH, MBA"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "027524",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02748745",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3348679",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in New York, NY
• Providers in New York, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.