Pine Bush Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

025835 Issued in NY

Legal business name

PINE BUSH PHARMACY INC

Practice address

2412 State Route 52 Ste 5
Pine Bush, NY 12566-7037

Phone

(845) 744-4221

Fax

(845) 744-2046

NPI assigned

Dec 23, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Riaz WattooNPI 1477877017

Title

Owner

Phone

(845) 744-4221

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PINE BUSH PHARMACY INC Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Pine Bush Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pine Bush Pharmacy Inc

  • Community/Retail Pharmacy
  • Pine Bush, NY
  • NPI 1710913447
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Riaz A Wattoo, PH

  • Pharmacist
  • Pine Bush, NY
  • NPI 1477877017
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768953600000",
    "number": "1083779730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1347",
            "city": "PINE BUSH",
            "state": "NY",
            "postal_code": "125661347",
            "telephone_number": "845-744-4221",
            "fax_number": "845-744-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 STATE ROUTE 52 STE 5",
            "city": "PINE BUSH",
            "state": "NY",
            "postal_code": "125667037",
            "telephone_number": "845-744-4221",
            "fax_number": "845-744-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE BUSH PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-23",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A",
        "authorized_official_last_name": "WATTOO",
        "authorized_official_first_name": "RIAZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-744-4221"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "025835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02385422",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2059454",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PINE BUSH PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wladys Emmanuel Perez
• Pine Bush Area Ambulance Corps Inc
• Pine Bush Central School District
• Pine Bush Dental Group
• Pine Bush Optometric PC
• Pine Bush Pharmacy Inc
• Pine Bush Schools
• Jill M Poluzzi
• Cheryl L. Porter, LPN
• Private Healthcare Facilities

• Community/Retail Pharmacy in Pine Bush, NY
• Providers in Pine Bush, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.