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Export Provider Record NPI 1174630354
Kph Healthcare Services, Inc.
Organization Subpart: NO
Active
NPI Number1174630354
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1174630354
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-08-24
Last Updated2024-07-03
Authorized OfficialElizabeth Marlow
Third Party Administrator
Phone: 3152873600
Mailing Address29 E Main St
Gouverneur, NY 13642-1401
United States
Phone: (315) 287-3600 | Fax: (315) 287-4291
📍 View Map
Primary Practice Address3873 Rome Rd
Pulaski, NY 13142-2488
United States
Phone: (315) 298-2024 | Fax: (315) 298-7756
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNY00561968-
Other (non-Medicare)-3343162Other ID Number-Commercial Number
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No333600000X – PharmacyNY004724
Yes3336C0003X – Pharmacy, Community/Retail Pharmacy--
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About NPI 1174630354

Kph Healthcare Services, Inc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1174630354. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Pulaski, NY. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-08-24. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1174630354?

NPI 1174630354 belongs to Kph Healthcare Services, Inc., a Pharmacy, Community/Retail Pharmacy in Pulaski, NY. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1174630354 active?

The current status of NPI 1174630354 in the NPPES registry is Active. The record was last updated on 2024-07-03.

What specialty is NPI 1174630354?

NPI 1174630354 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1174630354?

You can verify NPI 1174630354 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1174630354?

The primary practice address on file for NPI 1174630354 is 3873 Rome Rd, Pulaski, NY 13142-2488. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1174630354 issued?

NPI 1174630354 was first issued (enumerated) on 2006-08-24. The NPPES record was last updated on 2024-07-03.

Practice Location Map

Kph Healthcare Services, Inc. is located at 3873 Rome Rd, Pulaski, NY. Use the map below to find directions or verify the practice location.

📍 3873 Rome Rd, Pulaski, NY 13142-2488  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Kph Healthcare Services, Inc.. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1174630354. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy004724NY
Data Verified from CMS NPPES Last synced: 2026-08-24 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162