MEDICARE: KPH HEALTHCARE SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1407747157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KPH HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	29 E MAIN ST
Second Line	:
City	:	GOUVERNEUR
State	:	NY
Zip	:	13642-1401
Country	:	US
Telephone Number	:	315-287-3600
Fax Number	:	315-477-3241

Provider Business Practice Location Address
First Line	:	499 CANAL ST STE 3
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-3421
Country	:	US
Telephone Number	:	802-257-4204
Fax Number	:	802-257-4766

Authorized Official
Title or Position	:	VP PHARMACY SUPPLY CHAIN OPTIMIZATI
Name	:	BRIAN J SCOTT
Credential	:
Telephone Number	:	315-413-7800

Provider Enumeration Date	:	07/11/2025
Last Update Date	:	02/16/2026

Similar Medicare Providers

1801342209 — ABIGAIL REED
Practice Location Address:

499 CANAL ST STE 3
BRATTLEBORO, VT
05301-3421

Practice Phone: 802-257-4204
Practice Fax:

1356294748 — CANAL STREET PHARMACY, LLC
Practice Location Address:

447 CANAL ST
BRATTLEBORO, VT
05301-6619

Practice Phone: 802-428-4023
Practice Fax: 866-859-1169

1225033277 — DR. ANDREW HALTOF DO
Practice Location Address:

167 MAIN ST STE 310
BRATTLEBORO, VT
05301-3055

Practice Phone: 802-302-6337
Practice Fax: 802-490-2174

1265785174 — HEATHER MARIE KIERSTEAD CNM, WHNP
Practice Location Address:

6 HIGH ST
BRATTLEBORO, VT
05301-3001

Practice Phone: 866-476-1321
Practice Fax: 802-257-4342

1649324617 — ELIZABETH ELHARIS DAKAVANA LCMHC
Practice Location Address:

105 HIGHLAND STREET
BRATTLEBORO, VT
05301

Practice Phone: 802-254-6860
Practice Fax: 802-254-6860

1083878573 — EVE JUDITH BAKER L.M.T.
Practice Location Address:

72 COTTON MILL HL , B-103
BRATTLEBORO, VT
05301-7170

Practice Phone: 802-251-6059
Practice Fax:

Directions to “KPH HEALTHCARE SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.