Healthcare Provider Details
I. General information
NPI: 1427090844
Provider Name (Legal Business Name): BUFFALO WHEELCHAIR
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2006
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
318 EAST FAIRMONT AVE. SUITE #230
LAKEWOOD NY
14750-2007
US
IV. Provider business mailing address
1900 RIDGE RD SUITE #13
WEST SENECA NY
14224-3332
US
V. Phone/Fax
- Phone: 716-488-4200
- Fax: 716-488-4247
- Phone: 716-675-6500
- Fax: 716-675-6646
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JAMES
CRANE
TRAVIS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 716-675-6500