Organization Active NPI

Tag 2 Collaboration

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
National Provider Identifier
1245720010
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
TAG 2 COLLABORATION
Practice address
5860 Wynn Rd Ste B
Las Vegas, NV 89118-3063
Phone
(732) 515-5511
NPI assigned
May 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jack Mader
Title
President
Phone
(732) 515-5511

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

5860 Wynn Rd Ste B
Las Vegas, NV 89118-3063

Mailing address

5860 Wynn Rd Ste B
Las Vegas, NV 89118-3063
Phone (732) 515-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181109000612 NJ DME Supplier - Medical Supply Company 5294089264 Practice locations: Howell, NJ

National Provider Directory

National Provider Directory

Locations

103 W 2nd St
Ste 2
Howell, NJ 07731
Phone (732) 702-2300

5860 Wynn Rd
Ste B
Las Vegas, NV 89118
Phone (732) 515-5511

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775174400000",
    "number": "1245720010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 WYNN RD STE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183063",
            "telephone_number": "732-515-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 WYNN RD STE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183063",
            "telephone_number": "732-515-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAG 2 COLLABORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-16",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A",
        "authorized_official_last_name": "MADER",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-515-5511"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.