Healthcare Provider Details

I. General information

NPI: 1730121203
Provider Name (Legal Business Name): BUFFALO WHEELCHAIR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 03/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 MAIN ST
TOWANDA PA
18848-1600
US

IV. Provider business mailing address

1900 RIDGE RD SUITE #13
WEST SENECA NY
14224-3332
US

V. Phone/Fax

Practice location:
  • Phone: 570-265-7417
  • Fax: 570-265-7473
Mailing address:
  • Phone: 716-675-6500
  • Fax: 716-675-6646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JAMES CRANE TRAVIS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 716-675-6500