ABC SOURCE LLC (NPI# 1184010621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184010621 |
| Entity Type | Organization |
| Organization Name | ABC SOURCE LLC |
| Other Organization Name | ABC SOURCE PHARMACY |
| Practice Address |
2313 Avenue U Brooklyn NY 11229-4916 |
| Practice Telephone | 7186765556 |
| Practice Fax Number | 6468299181 |
| Mailing Telephone | 7186765556 |
| Mailing Fax Number | 6468299181 |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2020-01-09 |
| Authorized Official Name | DA XIAN SZE (OWNER) |
| Authorized Official Telephone | 3478757227 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
033311 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2151480 | 01 | |
| NY | 04172423 | 05 |
| Other Name | Type Code |
|---|---|
| ABC Source Pharmacy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporation Entity | ABC SOURCE LLC | 2309 AVENUE U , BROOKLYN, NEW YORK 11229 |
| Street Address |
2313 AVENUE U |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11229-4916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174036768 | Acare Staffing LLC | Clinic/Center | 2313 Avenue U, Brooklyn, NY 11229 | 2017-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063041291 | Nastasia Shygaieva | Counselor | 2 Ivan Court, House, Brooklyn, NY 11229 | 2020-04-08 |
| 1700430253 | Nicole Komisar | Case Manager/Care Coordinator | 2148 Ocean Avenu Suite 302, Brooklyn, NY 11229 | 2019-08-01 |
| 1639723950 | Refuah Diagnostics LLC | Technician | 1988 East 22nd Street, Ground Floor, Brooklyn, NY 11229 | 2019-07-25 |
| 1235792987 | Igor Kulishov | Counselor | 1623 Kings Highway, Brooklyn, Ny 11229, Brooklyn, NY 11229 | 2019-04-18 |
| 1477016145 | Natalia Roth | Nurse Practitioner | Visiting Nurse Service of New York, 1630 East 15 St, 3 Fl, NY 11229 | 2019-04-10 |
| 1942769930 | 1st Care Nj LLC | Case Management | 3919 Bedford Ave, Brooklyn, NY 11229 | 2019-03-18 |
| 1689138505 | Expert Home Care, Inc. | Home Health Aide | 1906 Kings Highway, 2nd Floor, Brooklyn, NY 11229 | 2019-01-24 |
| 1881167732 | Luba's Homecare Inc. | Home Health | 2518 Ocean Ave., Cellar Floor, Brooklyn, NY 11229 | 2019-01-03 |
| 1073084216 | Gem Therapy LLC | Early Intervention Provider Agency | 1674 East 19th Street, 2fl, Brooklyn, NY 11229 | 2018-12-16 |
| 1316412356 | Rina Barkhordarzadeh | Speech-Language Pathologist | 1925 Stuart Street, Brooklyn, NY 11229 | 2018-10-05 |
| Find all providers in zip 11229 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1124627302 | Elite Pharmacy Inc. | Pharmacy | 614a Grand St, Brooklyn, NY 11211-4802 | 2020-10-20 |
| 1043818289 | Xuwei Lin | Pharmacy | 8218 14th Ave, Brooklyn, NY 11228-3114 | 2020-10-10 |
| 1043817463 | Angella Samson | Pharmacy | 1346 Granville Payne Ave, Brooklyn, NY 11239-2103 | 2020-10-08 |
| 1366059792 | Community Healthcare Network Inc. | Pharmacy | 999 Blake Ave Fl 1, Brooklyn, NY 11208-3535 | 2020-09-29 |
| 1649885047 | Tree of Life Rx Inc | Pharmacy | 2472 Coney Island Ave, Brooklyn, NY 11223-5022 | 2020-09-11 |
| 1083227235 | Premium Health Inc | Pharmacy | 4510 16th Ave Fl 3, Brooklyn, NY 11204-1101 | 2020-08-27 |
| 1518579952 | Nostrand Drugs Rx Inc | Pharmacy | 385 Nostrand Ave, Brooklyn, NY 11216-1701 | 2020-08-18 |
| 1134738115 | Utica Express Pharmacy Inc | Pharmacy | 190 Utica Ave, Brooklyn, NY 11213-2939 | 2020-07-27 |
| 1609485895 | A5 Pharmacy Inc. | Pharmacy | 5323 7th Ave, Brooklyn, NY 11220-3120 | 2020-07-23 |
| Find all providers in BROOKLYN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.