MEDICARE: HUDSON HEADWATERS HEALTH NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1194610717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON HEADWATERS HEALTH NETWORK

Provider Business Mailing Address
First Line	:	416 S TYLER ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79101-2346
Country	:	US
Telephone Number	:	806-242-7782
Fax Number	:	518-633-1015

Provider Business Practice Location Address
First Line	:	1830 COUNTY ROUTE 64 STE A
Second Line	:
City	:	SALEM
State	:	NY
Zip	:	12865-3404
Country	:	US
Telephone Number	:	888-291-9195
Fax Number	:	518-633-1015

Authorized Official
Title or Position	:	PRESIDENT PHARMACY SERVICES
Name	:	JOEL WRIGHT
Credential	:
Telephone Number	:	806-242-7782

Provider Enumeration Date	:	06/12/2025
Last Update Date	:	03/09/2026

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