Provider Demographics
NPI:1376083287
Name:OBAN MEDICAL LLC
Entity Type:Organization
Organization Name:OBAN MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMARAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-653-8906
Mailing Address - Street 1:PO BOX 332505
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37133-2505
Mailing Address - Country:US
Mailing Address - Phone:615-653-8906
Mailing Address - Fax:
Practice Address - Street 1:845 HAWKINS BRANCH RD
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:TN
Practice Address - Zip Code:37022-4620
Practice Address - Country:US
Practice Address - Phone:615-653-8906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies