Healthcare Provider Details

I. General information

NPI: 1205005931
Provider Name (Legal Business Name): EHSOC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 07/29/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 ROUTE 12B
HAMILTON NY
13346-2113
US

IV. Provider business mailing address

2901 COURT STREET
SYRACUSE NY
13208-3217
US

V. Phone/Fax

Practice location:
  • Phone: 315-824-3453
  • Fax: 315-824-4301
Mailing address:
  • Phone: 315-455-8933
  • Fax: 315-455-8934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number3797-1
License Number StateNY

VIII. Authorized Official

Name: KIM BODINE
Title or Position: BILLING MANAGER
Credential:
Phone: 716-993-1200