Provider Demographics
NPI:1568647378
Name:THOMAS R RICH
Entity Type:Organization
Organization Name:THOMAS R RICH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-531-0320
Mailing Address - Street 1:215 MONMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1540
Mailing Address - Country:US
Mailing Address - Phone:732-531-0320
Mailing Address - Fax:732-531-2274
Practice Address - Street 1:215 MONMOUTH RD
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1540
Practice Address - Country:US
Practice Address - Phone:732-531-0320
Practice Address - Fax:732-531-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00170500332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0231140001Medicare NSC