Provider Demographics
NPI:1932121829
Name:TLC LINGERIE INC
Entity Type:Organization
Organization Name:TLC LINGERIE INC
Other - Org Name:TLC LINGERIE AND GIFTS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT - CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-655-9400
Mailing Address - Street 1:1402 BROADWATER AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-5324
Mailing Address - Country:US
Mailing Address - Phone:406-655-9400
Mailing Address - Fax:406-656-3865
Practice Address - Street 1:1402 BROADWATER AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-5324
Practice Address - Country:US
Practice Address - Phone:406-655-9400
Practice Address - Fax:406-656-3865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT311150OtherBLUE CROSS
MT1155850001Medicare ID - Type Unspecified