Provider Demographics
NPI:1184722043
Name:MEDCARE MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:MEDCARE MEDICAL SUPPLY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OFFICIER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:GALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-901-6800
Mailing Address - Street 1:PO BOX 1915
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754-1915
Mailing Address - Country:US
Mailing Address - Phone:732-901-6800
Mailing Address - Fax:732-341-3100
Practice Address - Street 1:3535 ROUTE 66 STE 3
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-2624
Practice Address - Country:US
Practice Address - Phone:732-901-6800
Practice Address - Fax:732-341-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE055185876Medicaid
MD3100243P0000Medicaid
NJ0125474Medicaid
PA1034866940001Medicaid