NPIMap

Organization Active NPI

Golub Corporation

Doing business as Price Chopper Pharmacy

  • Community/Retail Pharmacy
  • Rensselaer, NY
National Provider Identifier
1083627418
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
19752 Issued in NY
Legal business name
GOLUB CORPORATION
Doing business as
Price Chopper Pharmacy
Practice address
501 Columbia Tpke
Rensselaer, NY 12144-4542
Phone
(518) 479-4388
Fax
(518) 479-4389
NPI assigned
Aug 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kathleen Bryant
Title
VP of Pharmacy
Phone
(518) 379-1122

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 19752 NY Primary

Addresses

Primary practice location

501 Columbia Tpke
Rensselaer, NY 12144-4542

Mailing address

461 Nott St
MB#202
Schenectady, NY 12308-1812
Phone (518) 379-1618

Other identifiers 2

IdentifierTypeStateIssuer
01067376MedicaidNY
2065257OtherPK

Other names 1

  • PRICE CHOPPER PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090814000093 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7911059183 49 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newburgh, NY; Norwich, NY; Ogdensburg, NY; Oneida, NY; Oneonta, NY; Guilderland, NY; Palatine Bridge, NY; Plattsburgh, NY…
O20100930080934 NY DME Supplier - Pharmacy 7911059183 Practice locations: Rensselaer, NY

Other NPIs on the same Medicare enrollment 44

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 44

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Price Chopper Pharmacy #111501 Columbia Tpke, Rensselaer, NY 12144-4542(518) 479-4388 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Ostomy Supplies|Urological Supplies Accepts assignmentParticipating since Mar 29, 2000

National Provider Directory

National Provider Directory
Tax ID family
Price Chopper Pharmacy47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

501 Columbia Tpke
Rensselaer, NY 12144
Phone (518) 479-4388

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437523200000",
    "number": "1083627418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 NOTT ST",
            "address_2": "MB#202",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123081812",
            "telephone_number": "518-379-1618",
            "fax_number": "518-356-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 COLUMBIA TPKE",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121444542",
            "telephone_number": "518-479-4388",
            "fax_number": "518-479-4389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLUB CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2015-07-22",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "VP OF PHARMACY",
        "authorized_official_telephone_number": "518-379-1122"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "19752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01067376",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2065257",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRICE CHOPPER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rensselaer, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.