Healthcare Provider Details

I. General information

NPI: 1942608815
Provider Name (Legal Business Name): OCEAN HEALTH INITIATIVES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

686 ROUTE 70
LAKEHURST NJ
08733-2853
US

IV. Provider business mailing address

101 2ND ST
LAKEWOOD NJ
08701-3324
US

V. Phone/Fax

Practice location:
  • Phone: 732-408-1261
  • Fax: 732-408-1265
Mailing address:
  • Phone: 732-363-6655
  • Fax: 732-901-0277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: THERESA BERGER
Title or Position: CEO
Credential:
Phone: 732-363-6655