Healthcare Provider Details

I. General information

NPI: 1174741706
Provider Name (Legal Business Name): RONALD JOSEPHY GOLUBSKI R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N BROADWAY ST
TRUTH OR CONSEQUENCES NM
87901-2729
US

IV. Provider business mailing address

1005 N. LOCUST ST.
TRUTH OR CONSEQUENCES NM
87901-1525
US

V. Phone/Fax

Practice location:
  • Phone: 505-894-1079
  • Fax: 505-894-0585
Mailing address:
  • Phone: 505-894-1079
  • Fax: 505-894-0585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberNM5834
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: