Provider Demographics
NPI:1891686549
Name:KPH HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:KPH HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF MANAGED CARE CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:V
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-413-7800
Mailing Address - Street 1:29 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GOUVERNEUR
Mailing Address - State:NY
Mailing Address - Zip Code:13642-1401
Mailing Address - Country:US
Mailing Address - Phone:315-287-3600
Mailing Address - Fax:315-477-3241
Practice Address - Street 1:55 SPRINGFIELD PLAZA RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-2911
Practice Address - Country:US
Practice Address - Phone:802-885-5311
Practice Address - Fax:802-885-9330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy