Provider Information for 1346253762
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GOLUB CORPORATION
Other Names:Doing Business As:PRICE CHOPPER PHARMACYOrganization Subpart: NO
NPI: 1346253762
Last Updated: 2015-07-22
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1346253762 | ||||||||||||||||
| Enumeration Date | 2006-08-15 | ||||||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Authorized Official Information | Name: KATHLEEN BRYANT Title: VP of Pharmacy Phone: 5183791122 | ||||||||||||||||
| Mailing Address | 461 NOTT ST MB#202 SCHENECTADY, NY 12308-1812 United States Phone: 518-379-1618 | Fax:518-356-6978 | ||||||||||||||||
| Primary Practice Address | 320 W BRIDGE ST CATSKILL, NY 12414-1730 United States Phone: 518-943-3909 | Fax:518-943-9280 | ||||||||||||||||
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