Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lifesource Plus Inc

Organization Pharmacy · NPI 1366714974

Lifesource Plus Inc is a Pharmacy in Elmhurst, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8514 Queens Blvd
Elmhurst, NY 11373-4249
Phone: (718) 803-8393
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 031093 (NY)
Pharmacy Taxonomy 333600000X

Record details

NPI number1366714974
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Crystal Wong — President · (718) 803-8393
Other names Lifesource Pharmacy
NPI enumeratedJanuary 30, 2012
Last updated in NPPESMay 4, 2012
Mailing address8514 Queens Blvd, Elmhurst, NY 11373-4249

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