NPIMap

Organization Active NPI

KPH Healthcare Services, Inc.

Doing business as Healthdirect Institutional Pharmacy Services, Inc.

  • Long Term Care Pharmacy
  • Williston, VT
National Provider Identifier
1043327224
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
0380003336 Issued in VT
Legal business name
KPH HEALTHCARE SERVICES, INC.
Doing business as
Healthdirect Institutional Pharmacy Services, Inc.
Practice address
600 Blair Park Rd Ste 195
Williston, VT 05495-7529
Phone
(802) 878-9116
Fax
(802) 878-9273
NPI assigned
Aug 24, 2006
Last updated
Jul 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elizabeth M Marlow
Title
Third Party Administrator
Phone
(315) 287-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 0380003336 VT Primary

Addresses

Primary practice location

600 Blair Park Rd Ste 195
Williston, VT 05495-7529

Mailing address

600 Blair Park Rd Ste 195
Williston, VT 05495-7529

Other identifiers 2

IdentifierTypeStateIssuer
1009392MedicaidVT
4704006OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Healthdirect Institutional Pharmacy Services, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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…
O20140711002054 VT DME Supplier - Pharmacy 2365665130 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Williston, VT

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1043327224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BLAIR PARK RD STE 195",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BLAIR PARK RD STE 195",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957529",
            "telephone_number": "802-878-9116",
            "fax_number": "802-878-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KPH HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "MARLOW",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "THIRD PARTY ADMINISTRATOR",
        "authorized_official_telephone_number": "315-287-3600"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "VT",
            "license": "0380003336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009392",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4704006",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthdirect Institutional Pharmacy Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williston, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.