NPI Code Details Logo

NPI 1922467430

NPI 1922467430 : THE GOLUB CORPORATION : GUILDERLAND, NY

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1922467430
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    THE GOLUB CORPORATION 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/12/2016
-----------------------------------------------------
    Last Update Date     |    08/08/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2080 WESTERN AVE 
-----------------------------------------------------
    City                 |    GUILDERLAND
-----------------------------------------------------
    State                |    NY
-----------------------------------------------------
    Zip                  |    12084-9517
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    518-724-6752
-----------------------------------------------------
    Fax                  |    844-665-1407
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    461 NOTT ST MB#202
-----------------------------------------------------
    City                 |    SCHENECTADY
-----------------------------------------------------
    State                |    NY
-----------------------------------------------------
    Zip                  |    12308-1812
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    518-379-1618
-----------------------------------------------------
    Fax                  |    518-356-6978
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    VP OF PHARMACY
-----------------------------------------------------
    Name                 |     KATHLEEN  BRYANT 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    518-379-1618
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    333600000X
-----------------------------------------------------
    Taxonomy Name        |    Pharmacy
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    3336S0011X
-----------------------------------------------------
    Taxonomy Name        |    Specialty Pharmacy
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    3336C0003X
-----------------------------------------------------
    Taxonomy Name        |    Community/Retail Pharmacy
-----------------------------------------------------
    License Number       |    034474
-----------------------------------------------------
    License Number State |    NY
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.