Healthcare Provider Details

I. General information

NPI: 1275566473
Provider Name (Legal Business Name): AAA COMMUNITY SURGICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 RTE 37 W
TOMS RIVER NJ
08755-8046
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: 732-349-2990
  • Fax: 732-505-4450
Mailing address:
  • Phone: 732-349-2990
  • Fax: 732-505-4450

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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00211800
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

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