Provider Demographics
NPI:1629028808
Name:TLC OXYGEN & MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:TLC OXYGEN & MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-608-1665
Mailing Address - Street 1:2003 W CYPRESS CREEK RD STE 104
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1834
Mailing Address - Country:US
Mailing Address - Phone:844-402-2768
Mailing Address - Fax:
Practice Address - Street 1:2003 W CYPRESS CREEK RD STE 104
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1834
Practice Address - Country:US
Practice Address - Phone:844-402-2768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1907332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR9406OtherBLUE SHIELD PROVIDER #
FL4668210001Medicare ID - Type UnspecifiedMEDICARE PROV NUMBER