Organization
KPH HEALTHCARE SERVICES, INC.
Active
Other names
Kinney Drugs #83
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH M MARLOW (THIRD PARTY ADMINISTRATOR)
(315) 287-3600
Entity
Organization
Contact information
Practice address
40 ORISKANY BLVD, WHITESBORO, NY 13492-1318
(315) 292-1374
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
027850
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02753437
—
NY
Enumeration date
06/11/2006
Last updated
07/04/2024
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