Organization
KPH HEALTHCARE SERVICES, INC.
Active
Other names
Kinney Drugs #08
Organization subpart
No
Provider details
NPI number
Authorized official
LISA L WEIR (THIRD PARTY ADMINISTRATOR)
(315) 287-3600
Entity
Organization
Contact information
Practice address
22056 US ROUTE 11, WATERTOWN, NY 13601-1693
(315) 782-6530
(315) 786-0870
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
013569
NY
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00561977
—
NY
01
—
3347728
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/25/2006
Last updated
04/04/2014
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