KPH Healthcare Services, Inc.
Organization Active NPI Community/Retail Pharmacy · Barton, VT
NPI 1013203074 · NPPES record last updated Jul 3, 2024
Key facts
- NPI
- 1013203074
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 0380077454RPPP (VT)
- Legal business name
- KPH HEALTHCARE SERVICES, INC.
- Practice address
- 16 Church St
Barton, VT 05822-8511 - Phone
- (802) 525-4098
- Fax
- (802) 525-3794
- NPI assigned
- Jun 28, 2011
- Organization subpart
- No
Authorized official
- Name
- Elizabeth M Marlow
- Title
- Third Party Administrator
- Phone
- (315) 287-3600
Other NPIs on the same Medicare enrollment 22
Corporate family (same tax ID) 12
Member of 1
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Kinney Drugs #105 |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Canes and/or Crutches|Wa… | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VT
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Home Life Healthcare, Corp. |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110119001247 | VT | Part B Supplier - Mass Immunization (Roster Biller Only) | 9830217637 |
23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Cambridge, VT; Waterbury, VT; Vergennes, VT; South Burlington, VT; Shelburne, VT; Saint Johnsbury, VT; Saint Albans, VT; Randolph, VT… |
| O20120516000039 | VT | DME Supplier - Pharmacy | 9830217637 | Practice locations: Barton, VT |
National Provider Directory
- Tax ID family
- Kinney Drugs Inc 26
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 0380077454RPPP | VT | Yes |
Addresses
Primary practice location
16 Church St
Barton, VT 05822-8511
Mailing address
29 E Main St
Gouverneur, NY 13642-1401
Phone (315) 287-3600
Other names
- Kinney Drugs #105
Other providers in Barton, VT
- Amy D Kerr
- Mary King
- Kingdom Kare Rehabilitation Center
- Kingdom Rehab Center, LLC
- Virgil John Kovachich II
- Katy Kuchta
- Monica Menard
- Gail Carol Middlebrook
- North Country Hospital & Health Center Inc
- Orleans Central Supervisory Union
All providers in Barton, VT · Community/Retail Pharmacy in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.