Healthsource Pharmacy II Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

025501 Issued in NY

Legal business name

HEALTHSOURCE PHARMACY II INC

Doing business as

HEALTHSOURCE PHARMACY

Practice address

120 E 34TH St
New York, NY 10016-4609

Phone

(212) 481-6600

Fax

(212) 481-6606

NPI assigned

Feb 15, 2007

Organization subpart

No

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

Authorized official

Name

Boris Niyazov

Title

President

Phone

(212) 481-6600

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• HEALTHSOURCE PHARMACY Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1346383403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164609",
            "telephone_number": "212-481-6600",
            "fax_number": "212-481-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164609",
            "telephone_number": "212-481-6600",
            "fax_number": "212-481-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE PHARMACY II INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "NIYAZOV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-481-6600"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "025501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2064625",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02352789",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHSOURCE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.