Organization
KPH HEALTHCARE SERVICES, INC.
Active
Other names
Kinney Drugs #18
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH M MARLOW (THIRD PARTY ADMINISTRATOR)
(315) 287-3600
Entity
Organization
Contact information
Practice address
164 SWANTON RD, SAINT ALBANS, VT 05478-2601
(802) 524-6543
(802) 524-7269
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
0380001024
VT
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007349
—
VT
01
—
4701024
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
KI0007349
—
VT
Enumeration date
08/24/2006
Last updated
07/04/2024
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