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Contact Information

PINE BUSH PHARMACY INC
2412 RT 52 VALLEY SUPREME PLAZA
PINE BUSH, NY12566
 Phone: 845-744-4221
 Fax: 845-744-2046
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PINE BUSH PHARMACY INC

NPI # 1710913447
LBN Legal business name PINE BUSH PHARMACY INC
Authorized official RIAZ WATTOO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/24/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
NY License # 025835
NY Medicaid 02385422
Other 3331422 OTHER ID NUMBER-COMMERCIAL NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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