Healthcare Provider Details

I. General information

NPI: 1346357522
Provider Name (Legal Business Name): KINNEY DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 COLLEGE AVE
ITHACA NY
14850-4668
US

IV. Provider business mailing address

307 COLLEGE AVE
ITHACA NY
14850-4668
US

V. Phone/Fax

Practice location:
  • Phone: 607-273-6595
  • Fax: 607-273-6643
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number027570
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER JONES
Title or Position: THIRD PARTY COORDNTR
Credential:
Phone: 800-552-8663