Healthcare Provider Details

I. General information

NPI: 1467954958
Provider Name (Legal Business Name): POUND RIDGE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 WESTCHESTER AVE
POUND RIDGE NY
10576-2149
US

IV. Provider business mailing address

PO BOX 106
POUND RIDGE NY
10576-0106
US

V. Phone/Fax

Practice location:
  • Phone: 914-764-3330
  • Fax: 914-764-3331
Mailing address:
  • Phone: 516-662-9895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number036439
License Number StateNY

VIII. Authorized Official

Name: SONALI COSTA
Title or Position: OWNER & PHARMACY MANAGER/PIC/AO
Credential:
Phone: 203-869-2130