KPH HEALTHCARE SERVICES, INC. (NPI# 1558478735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558478735 |
| Entity Type | Organization |
| Organization Name | KPH HEALTHCARE SERVICES, INC. |
| Other Organization Name | KINNEY DRUGS #52 |
| Practice Address |
868 State Route 11 Champlain NY 12919-3131 |
| Mailing Address |
29 E Main St Gouverneur NY 13642-1401 |
| Practice Telephone | 5182985343 |
| Practice Fax Number | 5182983745 |
| Mailing Telephone | 3152873600 |
| Mailing Fax Number | 3152874291 |
| Enumeration Date | 2006-08-24 |
| 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 |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | 023691 | NY | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01832246 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3328259 | 01 |
| Other Name | Type Code |
|---|---|
| Kinney Drugs #52 | 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 |
868 STATE ROUTE 11 |
| City | CHAMPLAIN |
| State | NY |
| Zip Code | 12919-3131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104385368 | Christine O'brian | Pharmacist | 868 State Route 11, Champlain, NY 12919 | 2019-03-18 |
| 1528498763 | David Stetson Bombard II | Pharmacist | 868 State Route 11, Champlain, NY 12919 | 2013-11-26 |
| 1447436704 | Brion Forget | Pharmacist | 868 State Route 11, Champlain, NY 12919 | 2008-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144874603 | Tyler James King | Pharmacist | 887 Us-11, Champlain, NY 12919 | 2019-08-01 |
| 1851867782 | Courtney Elizabeth Shutts | Registered Nurse | 103 Rt 276, Champlain, NY 12919 | 2018-10-18 |
| 1659881555 | Kim Letourneau | Registered Nurse | 103 Route 276, Champlain, NY 12919 | 2017-10-05 |
| 1306157045 | John Boulton Southwick | Family Medicine | 76 Oak Street, Champlain, NY 12919 | 2010-06-28 |
| 1316262272 | Nganha Vo | Pharmacist | 868 Rt 11, Champlain, NY 12919 | 2010-04-05 |
| 1386976884 | Peter M Harrison | Pharmacist | 866 State Route 11, Champlain, NY 12919 | 2010-02-08 |
| 1881876670 | Carlinda Marie Hamilton | Pharmacist | 887 Route 11, Champlain, NY 12919 | 2007-12-04 |
| 1063493120 | William L Steinfeld | Dentist | 487 Route 11, Champlain, NY 12919 | 2005-11-07 |
| 1689661092 | Dorothea Burget Southwick | Physical Therapist | 34 Beeman Way, Champlain, NY 12919 | 2005-09-30 |
| 1730661000 | Nicole A Baker | Nurse Practitioner | 828 State Route 11, Champlain, NY 12919 | 2018-09-04 |
| Find all providers in zip 12919 | ||||
| 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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| 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.