MAIN SOURCE PHARMACY INC (NPI# 1689179178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689179178 |
| Entity Type | Organization |
| Organization Name | MAIN SOURCE PHARMACY INC |
| Other Organization Name | MAIN SOURCE PHARMACY |
| Practice Address |
347 Main St Huntington NY 11743-6914 |
| Mailing Address |
347b Main St Huntington NY 11743-6914 |
| Practice Telephone | 6317601114 |
| Practice Fax Number | 6317601035 |
| Mailing Telephone | 6317601114 |
| Mailing Fax Number | 6317601035 |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2018-09-17 |
| Authorized Official Name | SVETLANA NIYAZOVA (OWNER,RPH,AO) |
| Authorized Official Telephone | 6317601114 |
| 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 | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
036497 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2176773 | 01 |
| Other Name | Type Code |
|---|---|
| Main Source Pharmacy | Doing Business As Name - Organization |
| Street Address |
347 MAIN ST |
| City | HUNTINGTON |
| State | NY |
| Zip Code | 11743-6914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457328288 | Rosann Catherine Dalessandro | Internal Medicine | 347 Main St, Huntington, NY 11743-6914 | 2006-03-01 |
| 1043235393 | Barbara Ellen Livingston | Nurse Practitioner | 347 Main St, Huntington, NY 11743-6914 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447896477 | Peter C Gaal | Behavioral Analyst | 47 N. Woodhull Road, 2nd Floor, Huntington, NY 11743 | 2019-11-25 |
| 1902389299 | Taylor Bliss Dambrosio | Early Intervention Provider Agency | 38 Carnegie Ave, Huntington, NY 11743 | 2018-09-12 |
| 1639601750 | Speech and Hearing Services | Clinic/Center | 17 Brooks Ave Unit1, Huntington, NY 11743 | 2017-03-29 |
| 1174983456 | Helene Falcone | Registered Nurse | 264 W. 22nd St., Oakwood Primary Center, Hunt., NY 11743 | 2016-03-01 |
| 1124499470 | Thomas Hlenski | Social Worker | 4 Richard Lane, Huntington, NY 11743 | 2015-10-13 |
| 1174921308 | Jeanne Ginsberg | Counselor | 81 Knollwood Avenue, Huntington, NY 11743 | 2014-12-22 |
| 1770980534 | Emily Ann Sombke | Physician Assistant | 249 Manor Rd., Huntington, NY 11743 | 2014-11-21 |
| 1881096162 | Applied Health Chiropractic | Chiropractor | 12 Ash Pl, Huntington, NY 11743 | 2014-09-18 |
| 1265857643 | Ccs Medical Practice, Pllc | Public Health or Welfare | 17 Southdown Road, Huntington, NY 11743 | 2014-02-21 |
| 1255760682 | Ekaterina Femminella | Acupuncturist | 181 Main St Ste 105, Huntington, NY 11743 | 2013-11-06 |
| Find all providers in zip 11743 | ||||
| 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 |
|---|---|---|---|---|
| 1962037234 | Wfrx Pharmacy Inc. | Pharmacy | 1200 E Jericho Tpke, Huntington, NY 11743-5404 | 2020-03-07 |
| 1790209633 | O'neils Smart Health Pharmacy | Pharmacy | 221 North Main Street, Huntington, UT 84528-1094 | 2017-08-02 |
| 1770639114 | G & R LLC | Pharmacy | 361 Norway Ave, Huntington, WV 25705-1320 | 2007-01-26 |
| 1598846222 | Safe Rx Pharmacies Inc | Pharmacy | 335 4th Ave, Huntington, WV 25701-1223 | 2006-10-18 |
| 1467546770 | Pastm Inc | Pharmacy | 4352 5th Street Rd, Huntington, WV 25701-9558 | 2006-10-03 |
| 1619070372 | West Virginia Cvs Pharmacy LLC | Pharmacy | 5179 Us Route 60 E, Huntington, WV 25705-2003 | 2006-09-07 |
| 1447353131 | Hook Superx LLC | Pharmacy | 1901 N Jefferson St, Huntington, IN 46750-1352 | 2006-09-07 |
| 1881608032 | Rx Express Prescription Services Inc. | Pharmacy | 1842 E Jericho Tpke, Huntington, NY 11743-5796 | 2006-07-27 |
| 1861438319 | North Country Drugs Inc | Pharmacy | 227 229 East Main Street, Huntington, NY 11743 | 2006-06-22 |
| 1841898095 | Brittany Dolsen | Pharmacy | 2800 Wal Mart Dr, Huntington, IN 46750-7977 | 2020-10-10 |
| Find all providers in HUNTINGTON | ||||
| City | HUNTINGTON |
| Zip Code | 11743 |
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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.