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Organization

KPH HEALTHCARE SERVICES, INC.

Active
Other names
Kinney Drugs #40
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH M MARLOW (THIRD PARTY ADMINISTRATOR)
(315) 287-3600
Entity
Organization

Contact information

Practice address
6 VETERANS LANE, PLATTSBURGH, NY 12901-1235
(518) 561-8667
(518) 561-6739
Mailing address
29 E MAIN ST, GOUVERNEUR, NY 13642-1401
(315) 287-3600
(315) 287-4291

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
022225
NY
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01503502
NY
01
3352286
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
08/25/2006
Last updated
07/03/2024
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