Provider Demographics
NPI:1427155514
Name:RESIDENT SHOPPERS SERVICE
Entity type:Organization
Organization Name:RESIDENT SHOPPERS SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEFFERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-336-6870
Mailing Address - Street 1:PO BOX 4430
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13442-4430
Mailing Address - Country:US
Mailing Address - Phone:315-336-6870
Mailing Address - Fax:
Practice Address - Street 1:5946 SUCCESS DR
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-1743
Practice Address - Country:US
Practice Address - Phone:315-336-6870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5335700001Medicare NSC