Healthcare Provider Details

I. General information

NPI: 1023381415
Provider Name (Legal Business Name): GOLUB CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2585 SOUTH RD
POUGHKEEPSIE NY
12601-7000
US

IV. Provider business mailing address

461 NOTT STREET MB#202
SCHENECTADY NY
12308
US

V. Phone/Fax

Practice location:
  • Phone: 845-790-0150
  • Fax: 845-473-2498
Mailing address:
  • Phone: 518-379-1618
  • Fax: 518-356-6978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number031229
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN BRYANT
Title or Position: VP OF PHARMACY
Credential:
Phone: 518-379-1122