Healthcare Provider Details

I. General information

NPI: 1730457110
Provider Name (Legal Business Name): COMMUNITY SURGICAL SUPPLY OF TOMS RIVER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2011
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 NAUTILUS DR
MANAHAWKIN NJ
08050-2448
US

IV. Provider business mailing address

PO BOX 4686 1390 RT. 37 WEST
TOMS RIVER NJ
08754-4686
US

V. Phone/Fax

Practice location:
  • Phone: 609-597-2001
  • Fax:
Mailing address:
  • Phone: 732-349-2990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL D. FRIED
Title or Position: CEO
Credential:
Phone: 732-349-2990