Organization
INNOVATIVE SERVICE INC
Active
Parent organization
UPSTATE NEWCO LLC
Other names
Upstate Homecare
Organization subpart
Yes
Provider details
NPI number
Legal business name
UPSTATE NEWCO LLC
Authorized official
MR. EDWARD P KRAMM (CHIEF EXECUTIVE OFFICER)
(913) 515-6719
Entity
Organization
Contact information
Practice address
200 AIRPARK DR STE 60, ROCHESTER, NY 14624-5716
(585) 328-2050
(585) 328-2058
Mailing address
7506 STATE ROUTE 5, CLINTON, NY 13323-3654
(585) 423-9580
(315) 853-6087
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028984
PHARMACY LICENSE
NY
01
—
0701L003
DOH LICENSE NUMBER
NY
01
—
3358771
NCPDP
NY
Enumeration date
04/30/2008
Last updated
03/17/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us