MEDISOURCE PHARMACY LLC
MEDISOURCE PHARMACY LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1215197991, based in Plainview, NY. The organization lists 2 taxonomy classifications, with Specialty Pharmacy recorded as primary.
Getting there
The practice address on file is 720 OLD COUNTRY RD, Plainview, NY 11803. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 028939 | NY | Specialty Pharmacy primary |
This provider holds licence 028939 issued in NY. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Dme Supplier - Pharmacy
- PAC ID
- 8325245061
Enrolled in Medicare 3 times, across 1 state:
| State | Enrollment ID | Provider type |
|---|---|---|
| New York | O20100930059728 | Dme Supplier - Pharmacy |
| New York | O20210209000738 | Part B Supplier - Mass Immunization (roster Biller Only) |
| New York | O20260129002031 | Part B Supplier - Pharmacy |
Medicare enrolment is recorded as approved under the provider type Dme Supplier - Pharmacy. There are 3 separate enrolment records. Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Specialty Pharmacy covers
A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. NUCC Health Care Provider Taxonomy, code 3336S0011X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 3336S0011X | Specialty Pharmacy Specialty Pharmacy | 028939 | NY | primary |
| 3336C0003X | Community/Retail Pharmacy Community/Retail Pharmacy | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1215197991 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Jun 16, 2008 |
| Last updated | Jan 27, 2026 |
| Status | Active |
| Practice address |
720 OLD COUNTRY RD Plainview, NY 11803 (516) 605-0080 Fax (516) 605-0077 |
| Other identifiers |
3016644
· Medicaid (NY) 2070643 · Other |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 2 | 1 | 5 | 1 | 9 | 7 | 9 | 9 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 2 | 2 | 5 | 2 | 9 | 5 | 9 | 9 |
Sum = 69 · next multiple of 10 = 70 · check digit = 1 · actual last digit = 1
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.