Provider Demographics
NPI:1083785828
Name:CALKINS RESIDENTIAL SERVICES, LLC
Entity Type:Organization
Organization Name:CALKINS RESIDENTIAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:518-237-6670
Mailing Address - Street 1:57 REMSEN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-2832
Mailing Address - Country:US
Mailing Address - Phone:518-237-6670
Mailing Address - Fax:518-237-1227
Practice Address - Street 1:57 REMSEN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-2832
Practice Address - Country:US
Practice Address - Phone:518-237-6670
Practice Address - Fax:518-237-1227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5849270001Medicare NSC