Provider Demographics
NPI:1689689325
Name:UPSTATE COMMUNICATION RESOURCE, INC.
Entity Type:Organization
Organization Name:UPSTATE COMMUNICATION RESOURCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-264-0527
Mailing Address - Street 1:1 GROVE ST
Mailing Address - Street 2:SUITE #115
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1300
Mailing Address - Country:US
Mailing Address - Phone:585-264-0527
Mailing Address - Fax:
Practice Address - Street 1:1 GROVE ST
Practice Address - Street 2:SUITE #115
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1300
Practice Address - Country:US
Practice Address - Phone:585-264-0527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01258199Medicaid
NY1229230001Medicare ID - Type Unspecified