Provider Demographics
NPI:1659377042
Name:TOMS RIVER AMBULATORY SURGICAL CENTER
Entity Type:Organization
Organization Name:TOMS RIVER AMBULATORY SURGICAL CENTER
Other - Org Name:BEY LEA AMBULATORY SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-281-1020
Mailing Address - Street 1:54 BEY LEA RD
Mailing Address - Street 2:BLDG 2
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2891
Mailing Address - Country:US
Mailing Address - Phone:732-281-1020
Mailing Address - Fax:732-281-1024
Practice Address - Street 1:54 BEY LEA RD
Practice Address - Street 2:BLDG 2
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2891
Practice Address - Country:US
Practice Address - Phone:732-281-1020
Practice Address - Fax:732-281-1024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0000388Medicaid
NJ058775Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION