Provider Demographics
NPI:1992435887
Name:TLC MEDICAL LLC
Entity type:Organization
Organization Name:TLC MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHUBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-548-1112
Mailing Address - Street 1:PO BOX 1118
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14231-1118
Mailing Address - Country:US
Mailing Address - Phone:716-281-8529
Mailing Address - Fax:716-770-1918
Practice Address - Street 1:11300 STONEWALL JACKSON DR
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22551-4604
Practice Address - Country:US
Practice Address - Phone:716-281-8529
Practice Address - Fax:716-770-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies