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MAIN SOURCE PHARMACY, INC

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Company Details

Name: MAIN SOURCE PHARMACY, INC
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 21 Dec 2017 (7 years ago)
Entity Number: 5254030
ZIP code: 11743
County: Suffolk
Place of Formation: New York
Address: 347 MAIN STREET, HUNTINGTON, NY, United States, 11743
Principal Address: 347 MAIN ST, HUNTINGTON, NY, United States, 11743

Contact Details

Phone +1 631-760-1114

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
MAIN SOURCE PHARMACY, INC DOS Process Agent 347 MAIN STREET, HUNTINGTON, NY, United States, 11743

Chief Executive Officer

Name Role Address
SVETLANA NIYAZOVA Chief Executive Officer 347 MAIN ST, HUNTINGTON, NY, United States, 11743

National Provider Identifier

NPI Number:
1861259434
Certification Date:
2024-02-29

Authorized Person:

Name:
SVETLANA NIYAZOVA
Role:
OWNER, RPH, AO
Phone:

Taxonomy:

Selected Taxonomy:
3336L0003X - Long Term Care Pharmacy
Is Primary:
Yes

Contacts:

Fax:
6317601035

Form 5500 Series

Employer Identification Number (EIN):
823772203
Plan Year:
2023
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
0
Sponsors Telephone Number:

History

Start date End date Type Value
2024-01-29 2024-01-29 Address 347 MAIN ST, HUNTINGTON, NY, 11743, USA (Type of address: Chief Executive Officer)
2017-12-21 2024-01-29 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2017-12-21 2024-01-29 Address 347 MAIN STREET, HUNTINGTON, NY, 11743, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240129003376 2024-01-29 BIENNIAL STATEMENT 2024-01-29
221027001642 2022-10-27 BIENNIAL STATEMENT 2021-12-01
171221010010 2017-12-21 CERTIFICATE OF INCORPORATION 2017-12-21

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Date of last update: 24 Mar 2025

Sources: New York Secretary of State