Basic Information
| Provider Information | |||||||||
| NPI: | 1487826749 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY SURGICAL INFUSION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4686 | ||||||||
| Address2: | |||||||||
| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087544686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7323492990 | ||||||||
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| Practice Location | |||||||||
| Address1: | 365 TURNER INDUSTRIAL WAY | ||||||||
| Address2: | |||||||||
| City: | ASTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190143014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108599270 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2008 | ||||||||
| LastUpdateDate: | 12/30/2010 | ||||||||
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| AuthorizedOfficialLastName: | FRIED | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7323492990 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.