Water Street Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

026395 Issued in NY

Legal business name

WATER STREET PHARMACY INC.

Practice address

14 Water St
Dundee, NY 14837-1028

Phone

(607) 243-8114

Fax

(607) 243-8729

NPI assigned

Jan 19, 2007

Last updated

May 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracey L Knapp, R.PH.NPI 1760649313

Title

Owner

Phone

(607) 243-8114

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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.

  dba Village Drug

  • Community/Retail Pharmacy
  • Penn Yan, NY
  • NPI 1255758330

  2365751823

  Same PAC ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tracey Lea Knapp, R.PH.

  • Pharmacist
  • Dundee, NY
  • NPI 1760649313
  NPD (past) Authorized official
• Chelsea Leigh Travis

  • Pharmacist
  • Dundee, NY
  • NPI 1285159723
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1356494728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WATER ST",
            "city": "DUNDEE",
            "state": "NY",
            "postal_code": "148371028",
            "telephone_number": "607-243-8114",
            "fax_number": "607-243-8729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WATER ST",
            "city": "DUNDEE",
            "state": "NY",
            "postal_code": "148371028",
            "telephone_number": "607-243-8114",
            "fax_number": "607-243-8729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER STREET PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "KNAPP",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-243-8114",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "026395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02530505",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah J. Smith, FNP
• Soldiers & Sailors Memorial Hospital
• Karlene Marie Stackhouse, MA CCC-SLP
• Chelsea Leigh Travis
• Cynthia L Vollmer, OTR
• Christine Marie Weiss

• Community/Retail Pharmacy in Dundee, NY
• Providers in Dundee, 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 May 7, 2024; 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.