Organization
KPH HEALTHCARE SERVICES, INC.
Active
Other names
Kinney Drugs #07
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH M MARLOW (THIRD PARTY ADMINISTRATOR)
(315) 287-3600
Entity
Organization
Contact information
Practice address
3666 ROUTE 281, CORTLAND, NY 13045
(607) 753-9359
(607) 758-9569
Mailing address
29 E MAIN ST, GOUVERNEUR, NY 13642-1401
(315) 287-3600
(315) 287-4291
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
018366
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00861894
—
NY
Enumeration date
08/23/2006
Last updated
07/03/2024
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