Provider Demographics
NPI:1649727678
Name:ALBANY COLLEGE OF PHARMACY AND HEALTH SCIENCES
Entity type:Organization
Organization Name:ALBANY COLLEGE OF PHARMACY AND HEALTH SCIENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PHARMACIST, ASSISTANT PROF
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:CLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:803-351-2448
Mailing Address - Street 1:3 PENNY ROYAL RD
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-4456
Mailing Address - Country:US
Mailing Address - Phone:803-351-2448
Mailing Address - Fax:
Practice Address - Street 1:106 NEW SCOTLAND AVE
Practice Address - Street 2:DEPARTMENT OF PHARMACY PRACTICE
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3425
Practice Address - Country:US
Practice Address - Phone:518-694-7268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202213024261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center