Provider Demographics
NPI:1447406202
Name:MASTER TECK AUTOMOTIVE CORP.
Entity Type:Organization
Organization Name:MASTER TECK AUTOMOTIVE CORP.
Other - Org Name:BISON MOBILITY PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONSTANTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-730-4562
Mailing Address - Street 1:1615 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14206-1345
Mailing Address - Country:US
Mailing Address - Phone:716-240-9606
Mailing Address - Fax:
Practice Address - Street 1:1615 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14206-1345
Practice Address - Country:US
Practice Address - Phone:716-240-9606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies