KPH HEALTHCARE SERVICES, INC. (NPI# 1336347822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336347822 |
| Entity Type | Organization |
| Organization Name | KPH HEALTHCARE SERVICES, INC. |
| Other Organization Name | KINNEY DRUGS #92 |
| Practice Address |
261 Utica Boulevard Boonville NY 13309 |
| Mailing Address |
29 E Main St Gouverneur NY 13642-1401 |
| Practice Telephone | 3159422509 |
| Practice Fax Number | 3159423601 |
| Mailing Telephone | 3152873600 |
| Mailing Fax Number | 3152874291 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2014-04-04 |
| Authorized Official Name | LISA L WEIR (THIRD PARTY ADMINISTRATOR) |
| Authorized Official Telephone | 3152873600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
028488 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | STATE PHARMACY LICENSE | 028488 | 01 |
| NY | NCPDP | 3354812 | 01 |
| NY | 02886597 | 05 |
| Other Name | Type Code |
|---|---|
| Kinney Drugs #92 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851812853 | Kph Healthcare Services, Inc. | Pharmacy | 471 E Main St Unit 5, Gouverneur, NY 13642-1508 | 2017-06-29 |
| 1487996377 | Kph Healthcare Services, Inc. | Pharmacy | 2912 James St, Syracuse, NY 13206-2241 | 2013-03-19 |
| 1376893529 | Kph Healthcare Services, Inc. | Pharmacy | 307 Nottingham Rd., Syracuse, NY 13210 | 2012-09-14 |
| 1104183524 | Kph Healthcare Services, Inc. | Pharmacy | 47 Executive Drive, Shelburne, VT 05482 | 2012-04-23 |
| 1568731115 | Kph Healthcare Services, Inc. | Pharmacy | 161 Carey Road, Queensbury, NY 12804 | 2011-12-27 |
| 1427331784 | Kph Healthcare Services, Inc. | Pharmacy | 10212 Route 116, Hinesburg, VT 05461-9725 | 2011-09-23 |
| 1831417690 | Kph Healthcare Services, Inc. | Pharmacy | 151 Vermont Route 12 South, Randolph, VT 05060-9237 | 2010-05-04 |
| 1649455650 | Kph Healthcare Services, Inc. | Pharmacy | 1954 Saranac Ave, Lake Placid, NY 12946-1139 | 2008-01-09 |
| 1215135702 | Kph Healthcare Services, Inc. | Pharmacy | 407 Broad St, Lyndonville, VT 05851-5600 | 2007-07-05 |
| 1144428632 | Kph Healthcare Services, Inc. | Pharmacy | 957 Memorial Dr, Saint Johnsbury, VT 05819-9238 | 2007-07-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | KPH HEALTHCARE SERVICES, INC. | 29 E Main St, Gouvermeur, NY 13642 |
| New York State Corporations | KPH HEALTHCARE SERVICES, INC. | 29 East Main St, Gouverneur, New York 13642 |
| Connecticut Business Registrations | KPH HEALTHCARE SERVICES, INC. | 29 East Main Street, Gouverneur, NY 13642 |
| Oregon Corporations, Companies and Business Names | KPH HEALTHCARE SERVICES, INC. | 29 East Main Street, Gouverneur, NY 13642 |
| Colorado Business Entities | KPH Healthcare Services, Inc. | 29 East Main Street, Gouverneur, NY 13642 |
| Vermont Business Registrations | KPH HEALTHCARE SERVICES, INC. | 29 East Main St., Gouverneur, NY 13642 |
| Street Address |
261 UTICA BOULEVARD |
| City | BOONVILLE |
| State | NY |
| Zip Code | 13309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003090242 | Michele Van Dreason | Pharmacist | 261 Utica Boulevard, Boonville, NY 13309 | 2007-12-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447582606 | Jessica M Maurer | Pharmacist | 261 Utica Blvd, Boonville, NY 13309 | 2010-02-12 |
| 1104058791 | Tracy Bova | Registered Nurse | 13407 New York 12, Boonville, NY 13309 | 2009-08-14 |
| 1487784278 | Bruce Michael Renders | Dentist | 109 Ann Street, Boonville, NY 13309 | 2007-03-07 |
| 1992870570 | Richard L Sears Thomas N Caruso Dds PC | Dentist | 3 Schuyler St, Boonville, NY 13309 | 2006-11-21 |
| 1124265749 | Sushma Sapkota Pandey | Internal Medicine | 13407 State Route 12, Boonville Family Care, Boonville, NY 13309 | 2009-01-20 |
| 1144368127 | Ann F Mellen | Nurse Practitioner | 13407 State Route 12, Boonville, NY 13309 | 2007-02-02 |
| 1487678447 | Elizabeth Gleasman | Nurse Practitioner | 13407 State Route 12, Boonville, NY 13309 | 2006-07-26 |
| 1164465381 | Toby Kevin Davis | Clinical Neuropsychologist | 137 Main St., Boonville, NY 13309-0696 | 2006-06-14 |
| 1487646279 | Mountain Mental Health Group | Social Worker | 120 Schuyler St, Boonville, NY 13309-1005 | 2005-08-17 |
| 1144431511 | Susan Elizabeth Gydesen | Social Worker | 120 Schuyler St, Boonville, NY 13309-1005 | 2007-05-25 |
| Find all providers in zip 13309 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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|---|---|---|---|---|
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| 1073111951 | Pharmacy On Bay Street Inc. | Pharmacy | 1209 Bay St, Staten Island, NY 10305-3121 | 2020-10-13 |
| 1760080741 | Carol Pharmacy LLC | Pharmacy | 4230 Broadway, New York, NY 10033-3746 | 2020-10-13 |
| 1528666443 | Mvp Pharmacy Inc | Pharmacy | 920 Wheeler Rd Ste 920, Hauppauge, NY 11788-2900 | 2020-10-13 |
| 1477151512 | 101 Rx Pharmacy Inc | Pharmacy | 101 Rx Pharmacy Inc, 9718 101st Ave, Ozone Park, NY 11416 | 2020-10-12 |
| 1043818289 | Xuwei Lin | Pharmacy | 8218 14th Ave, Brooklyn, NY 11228-3114 | 2020-10-10 |
| 1043817463 | Angella Samson | Pharmacy | 1346 Granville Payne Ave, Brooklyn, NY 11239-2103 | 2020-10-08 |
| 1366059792 | Community Healthcare Network Inc. | Pharmacy | 999 Blake Ave Fl 1, Brooklyn, NY 11208-3535 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.