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Contact Information

KELLY'S PHARMACY INC.
4852 STATE ROUTE 81
GREENVILLE, NY12083
 Phone: 518-966-4800
 Fax: 518-966-4950
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for KELLY'S PHARMACY INC.

NPI Number 1891063012
LBN Legal business name KELLY'S PHARMACY INC.
Authorized official MARTIN KELLY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/02/2011
Last updated 05/21/2025 - More than a year ago
Identifiers
NY License # 030985
NY Medicaid 06305095
Other 2132755 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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