Provider Demographics
NPI:1194882779
Name:BENSONS SURGICAL AND DME SUPPLY LLC
Entity type:Organization
Organization Name:BENSONS SURGICAL AND DME SUPPLY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:O
Authorized Official - Last Name:DANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-322-4040
Mailing Address - Street 1:137 CARMEN RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-2118
Mailing Address - Country:US
Mailing Address - Phone:716-332-0404
Mailing Address - Fax:716-871-1998
Practice Address - Street 1:7220 PORTER RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-1600
Practice Address - Country:US
Practice Address - Phone:716-332-0404
Practice Address - Fax:716-871-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04988634Medicaid