Organization
INNOVATIVE SUPPLY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL LEBOVICS (VICE PRESIDENT)
(732) 363-3001
Entity
Organization
Contact information
Practice address
585 PROSPECT ST, UNIT 304, LAKEWOOD, NJ 08701-5073
(732) 363-3001
Mailing address
585 PROSPECT ST, UNIT 304, LAKEWOOD, NJ 08701-5073
(732) 363-3001
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
1509850
NJ
Other
Enumeration date
09/29/2009
Last updated
07/27/2026
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