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Organization

EMPIRE HOME INFUSION SERVICE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MICHELLE T MAZZACCO (VP/DIRECTOR)
(518) 270-1310
Entity
Organization

Contact information

Practice address
10 BLACKSMITH DR, SUITE 2, MALTA, NY 12020-4428
(518) 899-8103
(518) 899-2968
Mailing address
10 BLACKSMITH DR, SUITE 2, MALTA, NY 12020-4428
(518) 899-8103
(518) 899-2968

Taxonomy

Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000388
EMPIRE BC FACILITY
NY
01
00042512001
UNIVERA
NY
01
000478012001
BSNENY, SR BLUE
NY
05
01697465
NY
01
040401000497
FIDELIS
NY
01
07794179
GATEWAY
NY
01
10029567
CDPHP
NY
01
3317028
EPIC
NY
01
38242
GHI
NY
01
991638
MVP
NY
01
B1A15
EMPIRE BC
NY
01
CWW311
EMPHC-DME
NY
01
Y060817
CHAMPUS
NY
Enumeration date
06/08/2006
Last updated
03/05/2019
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