Organization
TAG 2 COLLABORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK MADER (PRESIDENT)
(732) 515-5511
Entity
Organization
Contact information
Practice address
5860 WYNN RD STE B, LAS VEGAS, NV 89118-3063
(732) 515-5511
Mailing address
5860 WYNN RD STE B, LAS VEGAS, NV 89118-3063
(732) 515-5511
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
05/16/2018
Last updated
04/03/2026
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