Provider Demographics
NPI:1912148396
Name:THE TUB TABLE COMPANY, INC.
Entity Type:Organization
Organization Name:THE TUB TABLE COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-317-5025
Mailing Address - Street 1:2910 W BALL RD
Mailing Address - Street 2:13
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-4845
Mailing Address - Country:US
Mailing Address - Phone:714-317-5025
Mailing Address - Fax:
Practice Address - Street 1:2910 W BALL RD
Practice Address - Street 2:13
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-4845
Practice Address - Country:US
Practice Address - Phone:714-317-5025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies