Healthcare Provider Details
I. General information
NPI: 1912011214
Provider Name (Legal Business Name): PRICE CHOPPER OPERATING CO INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2006
Last Update Date: 04/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 DUANESBURG RD
SCHENECTADY NY
12306-1058
US
IV. Provider business mailing address
461 NOTT ST MB#202
SCHENECTADY NY
12308-1812
US
V. Phone/Fax
- Phone: 844-431-7277
- Fax: 844-432-7277
- Phone: 518-379-1618
- Fax: 518-356-6978
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 024677 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHLEEN
BRYANT
Title or Position: VP OF PHARMACY
Credential:
Phone: 518-379-1122