Basic Information
| Provider Information | |||||||||
| NPI: | 1881962181 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY SURGICAL SUPPLY OF TOMS RIVER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4686 | ||||||||
| Address2: | 1390 RT. 37 WEST | ||||||||
| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087544686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7323492990 | ||||||||
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| Practice Location | |||||||||
| Address1: | 329 E JIMMIE LEEDS RD | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | GALLOWAY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082054110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094040314 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2011 | ||||||||
| LastUpdateDate: | 01/15/2013 | ||||||||
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| AuthorizedOfficialLastName: | FRIED | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7323492990 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332BP3500X | N | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition | 332BX2000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies |
No ID Information.