Provider Demographics
NPI:1992143721
Name:MOTRANCO GROUP INC
Entity type:Organization
Organization Name:MOTRANCO GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRZEWIECZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:716-725-7329
Mailing Address - Street 1:644 ELLICOTT ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1221
Mailing Address - Country:US
Mailing Address - Phone:716-247-5300
Mailing Address - Fax:716-681-1205
Practice Address - Street 1:5965 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1874
Practice Address - Country:US
Practice Address - Phone:716-362-1094
Practice Address - Fax:716-639-4804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-14
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
NY0319813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2140748OtherPK