Provider Demographics
NPI:1093040131
Name:TABOR INDUSTRIES, INC
Entity Type:Organization
Organization Name:TABOR INDUSTRIES, INC
Other - Org Name:LAKESIDE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:M
Authorized Official - Last Name:TABOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-636-9608
Mailing Address - Street 1:27 S STATE ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-3935
Mailing Address - Country:US
Mailing Address - Phone:503-636-9608
Mailing Address - Fax:503-675-1112
Practice Address - Street 1:27 S STATE ST
Practice Address - Street 2:SUITE 240
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3935
Practice Address - Country:US
Practice Address - Phone:503-636-9608
Practice Address - Fax:503-675-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier