Medisource Pharmacy LLC

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

License

028939 Issued in NY

Legal business name

MEDISOURCE PHARMACY LLC

Doing business as

Medisource Pharmacy

Practice address

720 Old Country Rd
Plainview, NY 11803-4929

Phone

(516) 605-0080

Fax

(516) 605-0077

NPI assigned

Jun 16, 2008

Organization subpart

No

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

Authorized official

Name

Roza Davidov

Title

Owner

Phone

(516) 615-2974

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Medisource Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elina Rozenfeld, RPH

  • Pharmacist
  • Plainview, NY
  • NPI 1750541439
  NPD

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1215197991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034929",
            "telephone_number": "516-605-0080",
            "fax_number": "516-605-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034929",
            "telephone_number": "516-605-0080",
            "fax_number": "516-605-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDISOURCE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "DAVIDOV",
        "authorized_official_first_name": "ROZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-615-2974"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NY",
            "license": "028939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3016644",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2070643",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medisource Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karina McMahon
• Alexandra McNicholl, M.S. CCC-SLP, TSSLD
• Jaclyn Danielle McQuade, RPA-C
• June Mecca
• Laicy George Mecheril, NP
• Jayne Mednick
• Rosalie Megur
• Frenny R Mehta, DPT
• Adam Mei
• Danielle Meill

• Specialty Pharmacy in Plainview, NY
• Providers in Plainview, NY by specialty
• Specialty Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.