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General NPI Number Information
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NPI Number | 1275546616
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Entity Type | Organization
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Legal Business Name | GOLUB CORPORATION
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 105 PLAZA LN
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City | COBLESKILL
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State | NY
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Zip | 12043-5020
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Country | US
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Telephone | 518-234-2528
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Fax | 518-234-8578
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Provider Business Mailing Address
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Address Line | 461 NOTT ST MB#202
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City | SCHENECTADY
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State | NY
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Zip | 12308-1812
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Country | US
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Telephone | 518-379-1618
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Fax | 518-356-6978
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Authorized Official
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Title or Position | VP OF PHARMACY
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Name | KATHLEEN BRYANT
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Credential |
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Telephone | 518-379-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 020701
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License Number State | NY
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