=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003685629
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE KATONAH WAY PHARMACY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2023
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 294 KATONAH AVE
-----------------------------------------------------
City | KATONAH
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10536-2148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-895-6505
-----------------------------------------------------
Fax | 914-401-9667
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 294 KATONAH AVE
-----------------------------------------------------
City | KATONAH
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10536-2148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-895-6505
-----------------------------------------------------
Fax | 914-401-9667
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | CHRIS RYDER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 914-393-9942
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------