1568568020 NPI number — OCEAN HOME HEALTH SUPPLY LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568568020 NPI number — OCEAN HOME HEALTH SUPPLY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OCEAN HOME HEALTH SUPPLY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COPD SERVICES BY OCEAN LLC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568568020
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 AIRPORT RD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08701-5960
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-961-1300
Provider Business Mailing Address Fax Number:
732-961-9897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1951 OLD CUTHBERT RD
Provider Second Line Business Practice Location Address:
SUITE 412
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08034-1411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-939-2970
Provider Business Practice Location Address Fax Number:
856-939-0540
Provider Enumeration Date:
09/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARNES
Authorized Official First Name:
YEHOSHUA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
856-437-7264

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9122605 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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