Organization
KPH HEALTHCARE SERVICES, INC.
Active
Other names
Kinney Drugs #90
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH M MARLOW (THIRD PARTY ADMINISTRATOR)
(315) 287-3600
Entity
Organization
Contact information
Practice address
115 ONEIDA ST, FULTON, NY 13069-1227
(315) 593-2158
(315) 598-5225
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
027994
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02785793
—
NY
01
—
3351917
NCPDP
NY
Enumeration date
09/06/2006
Last updated
07/03/2024
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