| Organization Name: | SHOREMARK MEDICAL, LLC |
| NPI Number: | 1487986444 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILIP GEORGE PASSES (MANAGER) |
| Mailing Address: | 911 Main St Belmar |
| State: | NJ US |
| Postal Code: | 077192723 |
| Phone Number: | 7322923135 |
| Fax Number: | 7322802872 |
| NPI Enumeration Date: | 02/02/2010 |
| NPI Last Update Date: | 02/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |