Medisource Pharmacy LLC
NPI 1215197991 · Specialty Pharmacy · Plainview, NY
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Medisource Pharmacy LLC is a Specialty Pharmacy organization in Plainview, NY (NPI 1215197991).
Provider details
- NPI number
- 1215197991
- Entity type
- Organization
- Primary specialty
- Specialty PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Roza Davidov, Owner(516) 615-2974
Specialties & taxonomies
Suppliers
- Community/Retail Pharmacy3336C0003X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Medisource Pharmacy
Registry dates
- Enumerated
- 2008-06-16
- Last updated
- 2026-01-27
- Certified
- 2026-01-27
Frequently asked questions
- What is Medisource Pharmacy LLC's NPI number?
- Medisource Pharmacy LLC's National Provider Identifier (NPI) is 1215197991, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Medisource Pharmacy LLC?
- Medisource Pharmacy LLC is classified in the NPPES registry as Specialty Pharmacy (Suppliers).
- Where is Medisource Pharmacy LLC located?
- Medisource Pharmacy LLC's practice location on file with NPPES is 720 Old Country Rd, Plainview, NY 11803-4929.
- What is Medisource Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Medisource Pharmacy LLC is (516) 605-0080.
- Does Medisource Pharmacy LLC accept Medicare?
- Medisource Pharmacy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Medisource Pharmacy LLC?
- The authorized official listed on Medisource Pharmacy LLC's NPPES record is Roza Davidov, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Medisource Pharmacy LLC's NPI active?
- Yes — Medisource Pharmacy LLC's NPI (1215197991) is active in the NPPES registry as of the last update on 2026-01-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.