Healthcare Provider Details

I. General information

NPI: 1215081823
Provider Name (Legal Business Name): MMS BUFFALO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12659 US HIGHWAY 27 N
BERRY KY
41003-9022
US

IV. Provider business mailing address

12659 US HIGHWAY 27 N
BERRY KY
41003-9022
US

V. Phone/Fax

Practice location:
  • Phone: 859-234-5333
  • Fax: 859-234-9162
Mailing address:
  • Phone: 859-234-5333
  • Fax: 859-234-9162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID G KAUDERER
Title or Position: VICE PRESIDENT
Credential:
Phone: 716-693-3747