Healthcare Provider Details

I. General information

NPI: 1144137621
Provider Name (Legal Business Name): KINNEY HOMECARE EQUIPMENT AND SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 KELLOGG RD STE 1
NEW HARTFORD NY
13413-2850
US

IV. Provider business mailing address

29 E MAIN ST
GOUVERNEUR NY
13642-1401
US

V. Phone/Fax

Practice location:
  • Phone: 315-913-1021
  • Fax: 315-913-2361
Mailing address:
  • Phone: 315-287-3600
  • Fax: 315-477-3241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateNULL

VIII. Authorized Official

Name: ELIZABETH MARLOW
Title or Position: THIRD PARTY ADMINISTRATOR
Credential:
Phone: 315-287-3600