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ISLAND MEDICAL PA
NPI 1639587801
Non-Pharmacy Dispensing Site in Ship Bottom, NJ

Active since July 31, 2014
1812 LONG BEACH BLVD, SHIP BOTTOM, NJ 08008(609) 494-2323 Get Directions Write a Review

NPPES record last updated: July 31, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Island Medical Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ISLAND MEDICAL PA (NPI 1639587801) is a healthcare organization registered as a non-pharmacy dispensing site in Ship Bottom, New Jersey and active in the NPI registry since July 2014. The organization lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1639587801
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameISLAND MEDICAL PA
Location Address1812 LONG BEACH BLVDShip Bottom, NJ 08008-4443
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(609) 494-2323
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateJuly 31, 2014
✔ NPI 1639587801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in NJ · 25MA05374000
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
1812 LONG BEACH BLVD, Ship Bottom, NJ 08008
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTINA LEVINE FNP
Nurse Practitioner (Family)
1812 LONG BEACH BLVD
SHIP BOTTOM, NJ 08008
Ocean County (609) 494-2323
ISLAND MEDICAL PROFESSIONAL ASSOCIATION
Family Medicine
1812 LONG BEACH BLVD
SHIP BOTTOM, NJ 08008
Ocean County (609) 494-2323
DR. HARRY L LARKIN M.D.
Family Medicine
1812 LONG BEACH BLVD
SHIP BOTTOM, NJ 08008
Ocean County (609) 494-2323
DR. PAUL WILLIAM PROSPERI D.O.
Family Medicine
1812 LONG BEACH BLVD
SHIP BOTTOM, NJ 08008
Ocean County (609) 494-2323
DR. JAMES NOLAND SUDDETH M.D.
Family Medicine
1812 LONG BEACH BLVD
SHIP BOTTOM, NJ 08008
Ocean County (609) 494-2323

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Island Medical PA's NPI number?

The NPI number for Island Medical PA is 1639587801. It was assigned to this organization in the NPPES registry on July 31, 2014.

Where is Island Medical PA located?

Island Medical PA is located at 1812 Long Beach Blvd, Ship Bottom, NJ 08008. The listed phone number is (609) 494-2323.

What is Island Medical PA's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Island Medical PA was last updated on July 31, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.