Healthcare Provider Details

I. General information

NPI: 1659527562
Provider Name (Legal Business Name): COMMUNITY SURGICAL SUPPLY OF TOMS RIVER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11254 SEBRING DR
CINCINNATI OH
45240-4600
US

IV. Provider business mailing address

220 W GERMANTOWN PIKE STE 250
PLYMOUTH MEETING PA
19462-1437
US

V. Phone/Fax

Practice location:
  • Phone: 513-674-1970
  • Fax:
Mailing address:
  • Phone: 610-630-6357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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 TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN P GRIGGS
Title or Position: CEO
Credential:
Phone: 610-630-6357