NPIMap

Organization Active NPI

KPH Healthcare Services, Inc.

  • Community/Retail Pharmacy
  • Saint Albans, VT
National Provider Identifier
1326155508
Registry record updated Jul 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KPH HEALTHCARE SERVICES, INC.
Practice address
164 Swanton Rd
Saint Albans, VT 05478-2601
Phone
(802) 524-6543
Fax
(802) 524-7269
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 4, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 0380001024 VT
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

164 Swanton Rd
Saint Albans, VT 05478-2601

Mailing address

29 E Main St
Gouverneur, NY 13642-1401
Phone (315) 287-3600

Other identifiers 3

IdentifierTypeStateIssuer
4701024OtherOTHER ID NUMBER-COMMERCIAL NUMBER
0007349MedicaidVT
KI0007349MedicaidVT

Other names 1

  • Kinney Drugs #18 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930026879 VT DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 9830217637 Practice locations: Saint Albans, VT
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…

Other NPIs on the same Medicare enrollment 22

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

View all 22

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
47D2235390Kinney Drugs #18164 Swanton Rd, St Albans, VT 05478Certificate of waiverSep 8, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
KPH Healthcare Services Inc164 Swanton Rd, Saint Albans, VT 05478-2601(802) 524-6543 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 assignmentParticipating since Mar 1, 2020

National Provider Directory

National Provider Directory
Tax ID family
Kinney Drugs Inc 2687 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Member of 1

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

Locations

164 Swanton Rd
Saint Albans, VT 05478
Phone (802) 524-5656

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Home Life Healthcare, Corp.Hoffman Estates, IL, CCN 148166 Home health agency 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2020

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1720051200000",
    "number": "1326155508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 E MAIN ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421401",
            "telephone_number": "315-287-3600",
            "fax_number": "315-287-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SWANTON RD",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054782601",
            "telephone_number": "802-524-6543",
            "fax_number": "802-524-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KPH HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VT",
            "license": "0380001024",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4701024",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007349",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KI0007349",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kinney Drugs #18",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Albans, VT

Sources for this page

Verify at the official NPI Registry.