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Contact Information

KPH HEALTHCARE SERVICES, INC.
596 ROUTE 11
TULLY, NY13159
 Phone: 315-696-8796
 Fax: 315-696-6145
 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 KPH HEALTHCARE SERVICES, INC.

NPI Number 1992812176
LBN Legal business name KPH HEALTHCARE SERVICES, INC.
Authorized official ELIZABETH MARLOW - (THIRD PARTY ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/24/2006
Last updated 07/04/2024 - More than a year ago
Identifiers
NY License # 026934
NY Medicaid 02620419
Other 3340255 OTHER ID NUMBER-COMMERCIAL NUMBER
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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