Provider Demographics
NPI:1700812476
Name:AAA COMMUNITY SURGICAL SUPPLY INC
Entity Type:Organization
Organization Name:AAA COMMUNITY SURGICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRIED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-349-2990
Mailing Address - Street 1:PO BOX 4686
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754-4686
Mailing Address - Country:US
Mailing Address - Phone:732-349-2990
Mailing Address - Fax:
Practice Address - Street 1:515 E EDGAR RD
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-2403
Practice Address - Country:US
Practice Address - Phone:908-523-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5419220004Medicare ID - Type Unspecified