Water Street Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

032684 Issued in NY

Legal business name

WATER STREET PHARMACY, INC.

Doing business as

Village Drug

Practice address

126 Main St
Penn Yan, NY 14527-1219

Phone

(315) 536-0100

Fax

(315) 536-0109

NPI assigned

Mar 26, 2014

Organization subpart

Yes

Parent organization

WATER STREET PHARMACY, INC.As reported in NPPES

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

Authorized official

Name

Tracey Knapp, RPH

Title

President

Phone

(315) 536-0100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Village Drug Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Water Street Pharmacy Inc.

  • Community/Retail Pharmacy
  • Dundee, NY
  • NPI 1356494728

  2365751823

  Same PAC ID

Part of

Water Street Pharmacy Inc

Locations

Practitioners 1

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

• Scott C Tucker, RPH

  • Pharmacist
  • Penn Yan, NY
  • NPI 1467784868
  NPD (past)

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1255758330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MAIN ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271219",
            "telephone_number": "315-536-0100",
            "fax_number": "315-536-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MAIN ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271219",
            "telephone_number": "315-536-0100",
            "fax_number": "315-536-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER STREET PHARMACY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WATER STREET PHARMACY, INC.",
        "enumeration_date": "2014-03-26",
        "last_updated": "2025-09-11",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "KNAPP",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-536-0100",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04239112",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Lynn Walk-Reinard, M.D.
• Karen Long Walker
• Stacey Ann Walker, M.D.
• Alissa Blake Walruth, LMHC-D
• Water Street Pharmacy Inc.
• Barbara J Weld, BACHELORS DEGREE
• Kathryn Ann Wiley, OT
• Susan B. Williams, MS
• Yates County Chapter Nysarc, Inc
• Yates County Chapter Nysarc, Inc

• Community/Retail Pharmacy in Penn Yan, NY
• Providers in Penn Yan, 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 Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.