Basic Information
| Provider Information | |||||||||
| NPI: | 1013312859 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | OCEAN COUNTY HEALTHCARE LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | THOMPSON HEALTHCARE AND SPORTS MEDICINE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 411 ROUTE 9 | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | LANOKA HARBOR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087342818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099713500 | ||||||||
| FaxNumber: | 6099713545 | ||||||||
| Practice Location | |||||||||
| Address1: | 411 ROUTE 9 | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | LANOKA HARBOR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087342818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099713500 | ||||||||
| FaxNumber: | 6099713545 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2014 | ||||||||
| LastUpdateDate: | 10/22/2014 | ||||||||
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| AuthorizedOfficialLastName: | THOMPSON | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6099713500 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.