Provider Demographics
NPI:1871948927
Name:THOMAS A. CABLE OD, INC
Entity type:Organization
Organization Name:THOMAS A. CABLE OD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CABLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:517-458-6130
Mailing Address - Street 1:205 NORTH ST
Mailing Address - Street 2:PO BOX 8
Mailing Address - City:MORENCI
Mailing Address - State:MI
Mailing Address - Zip Code:49256-1333
Mailing Address - Country:US
Mailing Address - Phone:517-458-6130
Mailing Address - Fax:517-458-3332
Practice Address - Street 1:205 NORTH ST
Practice Address - Street 2:
Practice Address - City:MORENCI
Practice Address - State:MI
Practice Address - Zip Code:49256-1333
Practice Address - Country:US
Practice Address - Phone:517-458-6130
Practice Address - Fax:517-458-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002393332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies