Healthcare Provider Details
I. General information
NPI: 1508157959
Provider Name (Legal Business Name): INNOVATIVE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/20/2011
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
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
- Phone: 315-437-1627
- Fax: 315-437-7931
- Phone: 315-853-1280
- Fax: 315-853-6087
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
EDWARD
P
KRAMM
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 913-515-6719