Healthcare Provider Details

I. General information

NPI: 1417861295
Provider Name (Legal Business Name): STUBBS AND CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 5TH AVE
NEW YORK NY
10037-1610
US

IV. Provider business mailing address

2300 5TH AVE
NEW YORK NY
10037-1610
US

V. Phone/Fax

Practice location:
  • Phone: 802-265-6694
  • Fax:
Mailing address:
  • Phone: 802-265-6694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARILYN M STUBBLEFIELD
Title or Position: OWNER
Credential:
Phone: 802-265-6694