Wayne LTC Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

029086 Issued in NY

Legal business name

WAYNE LTC PHARMACY INC

Doing business as

Wolcott Pharmacy

Practice address

12018 E Main St
Wolcott, NY 14590-1022

Phone

(315) 594-2222

Fax

(315) 594-2227

NPI assigned

Sep 22, 2008

Last updated

Sep 19, 2025By 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

Darren Pynn, BS PHARMACY

Title

President

Phone

(315) 594-2222

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Wolcott Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1700036258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 89",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145130089",
            "telephone_number": "315-594-2222",
            "fax_number": "315-594-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12018 E MAIN ST",
            "city": "WOLCOTT",
            "state": "NY",
            "postal_code": "145901022",
            "telephone_number": "315-594-2222",
            "fax_number": "315-594-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE LTC PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-22",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "PYNN",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-594-2222",
        "authorized_official_credential": "BS PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "029086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03074884",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2117616",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wolcott Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wolcott Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Wolcott, NY
• Providers in Wolcott, 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 19, 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.