{
  "npi": "1780211789",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "EDWARD",
    "authorized_official_last_name": "KRAMM",
    "authorized_official_middle_name": "P",
    "authorized_official_name_prefix": "Mr.",
    "authorized_official_telephone_number": "9135156719",
    "authorized_official_title_or_position": "Chief Executive Officer",
    "certification_date": "2026-08-30",
    "enumeration_date": "2020-03-27",
    "last_updated": "2026-08-30",
    "organization_name": "INNOVATIVE SERVICES INC",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "UPSTATE NEWCO LLC",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "855 SW 78TH AVE # C200",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "PLANTATION",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "954-385-7324",
      "postal_code": "333243223",
      "state": "FL",
      "telephone_number": "954-385-7322"
    },
    {
      "address_1": "25 POST RD STE 5",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "COLONIE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "518-375-2709",
      "postal_code": "122056751",
      "state": "NY",
      "telephone_number": "518-801-0510"
    }
  ],
  "taxonomies": [
    {
      "code": "251F00000X",
      "desc": "Home Infusion",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "251J00000X",
      "desc": "Nursing Care",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "332BP3500X",
      "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "333600000X",
      "desc": "Pharmacy",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "3336H0001X",
      "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Suppliers — Pharmacy, Home Infusion Therapy Pharmacy",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "58",
        "medicare_type": "Medical Supply Company with Pharmacist"
      },
      {
        "medicare_code": "A5",
        "medicare_type": "Pharmacy"
      },
      {
        "medicare_code": "D6",
        "medicare_type": "Home Infusion Therapy Services"
      }
    ]
  }
}