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General NPI Number Information
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NPI Number | 1356494728
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Entity Type | Organization
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Legal Business Name | WATER STREET PHARMACY INC.
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 14 WATER ST
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City | DUNDEE
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State | NY
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Zip | 14837-1028
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Country | US
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Telephone | 607-243-8114
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Fax | 607-243-8729
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Provider Business Mailing Address
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Address Line | 14 WATER ST
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City | DUNDEE
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State | NY
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Zip | 14837-1028
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Country | US
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Telephone | 607-243-8114
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Fax | 607-243-8729
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Authorized Official
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Title or Position | OWNER
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Name | TRACEY L KNAPP
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Credential | R.PH.
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Telephone | 607-243-8114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 026395
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License Number State | NY
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