Provider Demographics
NPI:1851842769
Name:OCEAN HEALTH INITIATIVES INC
Entity Type:Organization
Organization Name:OCEAN HEALTH INITIATIVES INC
Other - Org Name:OCEAN HEALTH INITIATIVES,INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-363-6655
Mailing Address - Street 1:101 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3324
Mailing Address - Country:US
Mailing Address - Phone:732-363-6655
Mailing Address - Fax:
Practice Address - Street 1:798 COUNTY ROAD 539
Practice Address - Street 2:BUILDING #3
Practice Address - City:LITTLE EGG HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08087-4203
Practice Address - Country:US
Practice Address - Phone:732-363-6655
Practice Address - Fax:609-879-5695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00754200333600000X
3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2165743OtherPK