MEDICARE: KP RX LLC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1700736709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KP RX LLC

Provider Business Mailing Address
First Line	:	1300 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-1953
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-1953
Country	:	US
Telephone Number	:	347-888-9448
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	KLINTI H
Credential	:
Telephone Number	:	347-888-9448

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “KP RX LLC ” Practice Location

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