Provider Demographics
NPI:1073595781
Name:MONMOUTH OCEAN HOSPITAL SERVICE CORPORATION
Entity Type:Organization
Organization Name:MONMOUTH OCEAN HOSPITAL SERVICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:DEPAUL
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:MSC, CHE, FAHRMM
Authorized Official - Phone:732-919-3045
Mailing Address - Street 1:4806 MEGILL RD
Mailing Address - Street 2:SUITE # 10
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-6926
Mailing Address - Country:US
Mailing Address - Phone:732-919-3045
Mailing Address - Fax:732-919-2733
Practice Address - Street 1:4806 MEGILL RD
Practice Address - Street 2:SUITE # 10
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07753-6926
Practice Address - Country:US
Practice Address - Phone:732-919-3045
Practice Address - Fax:732-919-2733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1047473OtherHORIZON NJ HEALTH
NJ6647006Medicaid
NJ237596Medicare ID - Type Unspecified