Provider Demographics
NPI:1568490647
Name:BUFFALO HOSPITAL SUPPLY CO INC
Entity Type:Organization
Organization Name:BUFFALO HOSPITAL SUPPLY CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CORCORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-626-9400
Mailing Address - Street 1:4039 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1904
Mailing Address - Country:US
Mailing Address - Phone:716-626-9400
Mailing Address - Fax:716-626-4307
Practice Address - Street 1:4039 GENESEE ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14225-1904
Practice Address - Country:US
Practice Address - Phone:716-626-9400
Practice Address - Fax:716-626-4307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
00011187902OtherUNIVERA
000551035001OtherBLUE CROSS BLUE SHIELD
NY00987586Medicaid
111919GDOtherPREFERRED CARE GOLD
8290432OtherINDEPENDENT HEALTH
NY00987586Medicaid