MEDICARE: EMPIRE HOME INFUSION SERVICE 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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	44125	OTHER	NY	MVP
2	000478012002	OTHER	NY	BLUE SHIELD NENY
3	10029567	OTHER	NY	CDPHP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770551228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPIRE HOME INFUSION SERVICE INC

Provider Business Mailing Address
First Line	:	60 COHOES AVE
Second Line	:
City	:	GREEN ISLAND
State	:	NY
Zip	:	12183-1587
Country	:	US
Telephone Number	:	518-271-9600
Fax Number	:	518-271-3816

Provider Business Practice Location Address
First Line	:	60 COHOES AVE
Second Line	:
City	:	GREEN ISLAND
State	:	NY
Zip	:	12183-1587
Country	:	US
Telephone Number	:	518-271-9600
Fax Number	:	518-271-3816

Authorized Official
Title or Position	:	VP/DIRECTOR
Name	:	MRS. MICHELLE T MAZZACCO
Credential	:
Telephone Number	:	518-270-1310

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	03/07/2011

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