KPH Healthcare Services, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

KPH HEALTHCARE SERVICES, INC.

Practice address

7998 Route 31
Bridgeport, NY 13030-9473

Phone

(315) 633-0073

NPI assigned

Aug 24, 2006

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 identifiers 2

Other names 1

• Kinney Drugs #37 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.

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.

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

  Member Of

  NPD member

All facility ownership & control disclosures 1

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

Practitioners 7

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

• Michael Clary

  • Pharmacist
  • Bridgeport, NY
  • NPI 1629300819
  NPD (past)
• Kari Davis, PHARMD

  • Pharmacist
  • Bridgeport, NY
  • NPI 1720477896
  NPD (past)
• Emily Kuba

  • Pharmacist
  • Bridgeport, NY
  • NPI 1548802424
  NPD (past)
• Kimberly Michele Sexton

  • Pharmacist
  • Bridgeport, NY
  • NPI 1619231958
  NPD (past)
• Timothy Walsh, R.PH.

  • Pharmacist
  • Bridgeport, NY
  • NPI 1487838553
  NPD (past)
• Nicole Azzarello, PHARMD

  • Pharmacist
  • Sarasota, FL
  • NPI 1578897336
  NPD (past)
• Erica Paige Jackson, PHARMD

  • Pharmacist
  • Shamokin Dam, PA
  • NPI 1528672680
  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": "1902913189",
    "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": "7998 ROUTE 31",
            "city": "BRIDGEPORT",
            "state": "NY",
            "postal_code": "130309473",
            "telephone_number": "315-633-0073"
        }
    ],
    "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": "021711",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01404571",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3332323",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kinney Drugs #37",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kari Davis, PHARMD
• Dana Marie Delancey, DC, MS
• Dr Gary H Finnerty DDS PC
• Amy Hansen, OTR/L
• Carl Hoyt
• Emily Kuba
• Kyle Edward Kuhn, NREMT
• Linda Anne Lang, LPN
• Karen Janel Nash
• Beth P Norman, RN

• All providers in Bridgeport, NY
• 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.