Organization Active NPI

Williamson Pharmacy LLC

  • Pharmacy
  • Williamson, NY
National Provider Identifier
1215901905
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
027549 Issued in NY
Legal business name
WILLIAMSON PHARMACY LLC
Practice address
4102 Pearsall St
Williamson, NY 14589-9270
Phone
(315) 589-3333
Fax
(315) 589-3335
NPI assigned
Feb 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mark Hermenet
Title
Supervising Pharmacist
Phone
(315) 521-0646

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 027549 NY Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

4102 Pearsall St
Williamson, NY 14589-9270

Mailing address

4102 Pearsall St
Williamson, NY 14589-9270

Other identifiers 1

IdentifierTypeStateIssuer
3348883OtherOTHER ID NUMBER-COMMERCIAL NUMBER

National Provider Directory

National Provider Directory

Locations

4102 Pearsall St
Williamson, NY 14589
Phone (315) 589-3333

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1215901905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 PEARSALL ST",
            "city": "WILLIAMSON",
            "state": "NY",
            "postal_code": "145899270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PEARSALL ST",
            "city": "WILLIAMSON",
            "state": "NY",
            "postal_code": "145899270",
            "telephone_number": "315-589-3333",
            "fax_number": "315-589-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-17",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HERMENET",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "315-521-0646"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "027549",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3348883",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.