Organization
BUFFALO HOSPITAL SUPPLY CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN J CORCORAN (CHIEF OPERATING OFFICER)
(716) 626-9400
Entity
Organization
Contact information
Practice address
4039 GENESEE ST, BUFFALO, NY 14225-1904
(716) 626-9400
(716) 626-4307
Mailing address
4039 GENESEE ST, BUFFALO, NY 14225-1904
(716) 626-9400
(716) 626-4307
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011187902
UNIVERA
—
01
—
000551035001
BLUE CROSS BLUE SHIELD
—
05
—
00987586
—
NY
01
—
111919GD
PREFERRED CARE GOLD
—
01
—
8290432
INDEPENDENT HEALTH
—
Enumeration date
06/29/2006
Last updated
08/22/2020
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