Healthcare Provider Details

I. General information

NPI: 1003862020
Provider Name (Legal Business Name): INNOVATIVE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 THOMPSON RD
SYRACUSE NY
13211-2141
US

IV. Provider business mailing address

PO BOX 931769
ATLANTA GA
31193-1769
US

V. Phone/Fax

Practice location:
  • Phone: 315-437-1627
  • Fax: 315-437-7931
Mailing address:
  • Phone: 315-437-1627
  • Fax: 315-437-7931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number023530
License Number StateNY

VIII. Authorized Official

Name: EDWARD P KRAMM
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 913-515-6719