Provider Demographics
NPI:1790099620
Name:TB2G, INC.
Entity Type:Organization
Organization Name:TB2G, INC.
Other - Org Name:OXNARD MEDICLAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-486-5949
Mailing Address - Street 1:711 S. OXNARD BLVD.
Mailing Address - Street 2:#A
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-7146
Mailing Address - Country:US
Mailing Address - Phone:805-486-5949
Mailing Address - Fax:805-486-5919
Practice Address - Street 1:711 S. OXNARD BLVD.
Practice Address - Street 2:#A
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7146
Practice Address - Country:US
Practice Address - Phone:805-486-5949
Practice Address - Fax:805-486-5919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6444490001Medicare NSC