Provider Demographics
NPI:1790826105
Name:COMMUNITY SURGICAL SUPPLY OF TOMS RIVER, INC
Entity Type:Organization
Organization Name:COMMUNITY SURGICAL SUPPLY OF TOMS RIVER, INC
Other - Org Name:COMMUNITY SURGICAL SUPPLY OF TOMS RIVER, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-630-6357
Mailing Address - Street 1:220 W GERMANTOWN PIKE STE 250
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1437
Mailing Address - Country:US
Mailing Address - Phone:610-630-6357
Mailing Address - Fax:
Practice Address - Street 1:1390 ROUTE 37 W
Practice Address - Street 2:SUITE 1
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08754-4924
Practice Address - Country:US
Practice Address - Phone:732-349-2990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS006259003336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3145439OtherNCPDP
NJ3145439OtherNCPDP