Pharm Source Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PHARM SOURCE INC

Practice address

256 W Old Country Rd Unit B
Hicksville, NY 11801-4034

Phone

(516) 214-0255

NPI assigned

Jul 10, 2020

Organization subpart

No

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

Authorized official

Name

Firdos Mukadum

Title

Ceo

Phone

(516) 710-9555

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1467070912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 W OLD COUNTRY RD UNIT B",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014034",
            "telephone_number": "516-214-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 W OLD COUNTRY RD UNIT B",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014034",
            "telephone_number": "516-214-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARM SOURCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-10",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "MUKADUM",
        "authorized_official_first_name": "FIRDOS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "516-710-9555"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Elizabeth Peruvingal, PHARMD
• Peter a Chidichimo, PT,PC
• Peter Yelizar DDS PLLC
• Meaghan D Petersen, RN
• Laurie Pezzullo, LMSW, CHC, CDM
• Jonell Phelps
• Emery Philip
• Michael S Phillips
• Robert H Phillips, PH.D.
• Gleibys Phinney, R.N

• Durable Medical Equipment & Medical Supplies in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.