Provider Demographics
NPI:1851497325
Name:OCEAN HOME HEALTH SUPPLY, LLC
Entity Type:Organization
Organization Name:OCEAN HOME HEALTH SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-880-0473
Mailing Address - Street 1:1000 AIRPORT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5960
Mailing Address - Country:US
Mailing Address - Phone:732-961-1300
Mailing Address - Fax:732-961-9897
Practice Address - Street 1:1951 OLD CUTHBERT RD
Practice Address - Street 2:SUITE 412
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1411
Practice Address - Country:US
Practice Address - Phone:856-939-2970
Practice Address - Fax:856-939-0540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0046353Medicaid
NJ0046353Medicaid
5347950002Medicare NSC