Organization
KPH HEALTHCARE SERVICES, INC.
Active
Other names
Kinney Drugs #102
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH M MARLOW (THIRD PARTY ADMINISTRATOR)
(315) 287-3600
Entity
Organization
Contact information
Practice address
151 VERMONT ROUTE 12 SOUTH, RANDOLPH, VT 05060-9237
(802) 728-6284
(802) 728-6287
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
0380066144
VT
Other
Enumeration date
05/04/2010
Last updated
07/04/2024
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