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General NPI Number Information
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NPI Number | 1942246491
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Entity Type | Organization
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Legal Business Name | SCHENECTADY CNTY GLENDL NURSING FAC
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 59 HETCHELTOWN RD
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City | SCOTIA
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State | NY
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Zip | 12302-5506
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Country | US
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Telephone | 518-384-3635
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Fax | 518-399-5732
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Provider Business Mailing Address
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Address Line | 59 HETCHELTOWN RD
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City | SCOTIA
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State | NY
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Zip | 12302-5506
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Country | US
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Telephone | 518-384-3635
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Fax | 518-399-5732
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | JAMES PURCELL
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Credential |
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Telephone | 518-384-3635
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | NY016813
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License Number State | NY
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