Healthcare Provider Details

I. General information

NPI: 1730007477
Provider Name (Legal Business Name): TUSCON SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 MEDICAL CENTER DR SUITE 301
FAYETTEVILLE NY
13066
US

IV. Provider business mailing address

923 SAW MILL RIVER RD # 123
ARDSLEY NY
10502-1106
US

V. Phone/Fax

Practice location:
  • Phone: 315-418-3641
  • Fax:
Mailing address:
  • Phone: 315-418-3641
  • Fax:

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: FATEH MUHAMMAD
Title or Position: CEO
Credential:
Phone: 315-418-3641