MEDICARE: TOMS RIVER AMBULATORY SURGICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659377042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOMS RIVER AMBULATORY SURGICAL CENTER

Provider Business Mailing Address
First Line	:	54 BEY LEA RD
Second Line	:	BLDG 2
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2891
Country	:	US
Telephone Number	:	732-281-1020
Fax Number	:	732-281-1024

Provider Business Practice Location Address
First Line	:	54 BEY LEA RD
Second Line	:	BLDG 2
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2891
Country	:	US
Telephone Number	:	732-281-1020
Fax Number	:	732-281-1024

Authorized Official
Title or Position	:	BUSINESS ADMINISTRATOR
Name	:	MRS. DEBORAH LYNN BANNON
Credential	:
Telephone Number	:	732-281-1020

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/21/2022

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