KPH Healthcare Services, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

KPH HEALTHCARE SERVICES, INC.

Doing business as

Kinney Drugs #79

Practice address

437 Electronics Pkwy
Liverpool, NY 13088-6001

Phone

(315) 453-1750

Fax

(315) 453-1753

NPI assigned

Aug 24, 2006

Last updated

Jul 4, 2024By the provider in NPPES

Organization subpart

No

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

Addresses

Other names 1

• Kinney Drugs #79 Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Member of 1

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

• KPH Healthcare Services, Inc.

  dba Kinney Drugs #87

  • Community/Retail Pharmacy
  • Syracuse, NY
  • NPI 1790892974

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 1

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

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bret Michael Acchione, PHARMD

  • Pharmacist
  • Liverpool, NY
  • NPI 1003138876
  NPD (past)
• David S Calabria, R.PH

  • Pharmacist
  • Cicero, NY
  • NPI 1710201140
  NPD (past)
• Brian Conners, R.PH.

  • Pharmacist
  • Tully, NY
  • NPI 1922286566
  NPD (past)
• Kandyce J Daley, R.PH.

  • Pharmacist
  • Liverpool, NY
  • NPI 1295067759
  NPD (past)
• Natalia Daughton, R.PH.

  • Pharmacist
  • Liverpool, NY
  • NPI 1023291648
  NPD (past)
• Michelle Elisabeth Dequattro, PHARMD

  • Pharmacist
  • Auburn, NY
  • NPI 1811668791
  NPD (past)
• Daniel Justin Leska, PHARMD

  • Pharmacist
  • Liverpool, NY
  • NPI 1114661105
  NPD (past)
• Steven C Palmer

  • Pharmacist
  • Liverpool, NY
  • NPI 1114439635
  NPD (past)
• Mark Russo

  • Pharmacist
  • Liverpool, NY
  • NPI 1386976827
  NPD (past)
• Brian Tommarello, PHARMACIST

  • Pharmacist
  • Liverpool, NY
  • NPI 1326411299
  NPD (past)
• Austin Washburn

  • Pharmacist
  • Liverpool, NY
  • NPI 1669845426
  NPD (past)

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": "1619084894",
    "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": "437 ELECTRONICS PKWY",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130886001",
            "telephone_number": "315-453-1750",
            "fax_number": "315-453-1753"
        }
    ],
    "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": "NY",
            "license": "027484",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kinney Drugs #79",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samantha Marie Knapp
• Daisy Dawoon Ko, LMHC
• Kelly Kristina Kolodziejski, LCSW
• Kyle Kowalewski, PA-C
• Lisa R Kozma, LMT
• KPH Healthcare Services, Inc. (Kinney Drugs #51)
• Lauren Michelle Kraus, M.S. CCC-SLP, TSSLD
• Patricia Kriegisch Kondapi, CCC-SLP
• Bonnie M Krisak
• Nicholas Kruger

• Community/Retail Pharmacy in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.