Organization
KPH HEALTHCARE SERVICES, INC.
Active
Other names
Kinney Drugs #79
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH M MARLOW (THIRD PARTY ADMINISTRATOR)
(315) 287-3600
Entity
Organization
Contact information
Practice address
437 ELECTRONICS PKWY, LIVERPOOL, NY 13088-6001
(315) 453-1750
(315) 453-1753
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
027484
NY
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02692280
—
NY
01
—
3347540
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/24/2006
Last updated
07/04/2024
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