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

Medisource Pharmacy LLC

Organization Community/Retail Pharmacy · NPI 1215197991

Medisource Pharmacy LLC is a Community/Retail Pharmacy in Plainview, New York. Licensed in New York. Registered with an NPI since 2008.

Licensed in
NY
In the registry since
2008
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

720 Old Country Rd
Plainview, NY 11803-4929
Phone: (516) 605-0080
Fax: (516) 605-0077
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialty Pharmacy (primary) Taxonomy 3336S0011X · Licence 028939 (NY)
Community/Retail Pharmacy Taxonomy 3336C0003X

Record details

NPI number1215197991
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roza Davidov — Owner · (516) 615-2974
Other names Medisource Pharmacy
NPI enumeratedJune 16, 2008
Last updated in NPPESJanuary 27, 2026
Certification dateJanuary 27, 2026
Mailing address720 Old Country Rd, Plainview, NY 11803-4929

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