Organization
INNOVATIVE SERVICE INC
Active
Other names
Upstate Homecare
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALYCE M CROSSMAN (VP, CIO)
(315) 531-2800
Entity
Organization
Contact information
Practice address
3890 STATE ROUTE 5 AND 20, CANANDAIGUA, NY 14424-8101
(585) 394-9200
(585) 394-1485
Mailing address
3890 STATE ROUTE 5 AND 20, CANANDAIGUA, NY 14424-8101
(585) 394-9200
(585) 394-1485
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
07011004
NY
251J00000X
Nursing Care Agency
Primary
07011004
NY
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
3336H0001X
Home Infusion Therapy Pharmacy
023530
NY
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00895529
—
NY
05
—
01818419
—
NY
Enumeration date
05/23/2006
Last updated
09/11/2025
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