OrganizationActive
Innovative Supply Group, LLC
NPI 1164756755 · Parenteral & Enteral Nutrition Supplies (DME) · Lakewood, NJ
Provider details
- NPI number
- 1164756755
- Entity type
- Organization
- Primary specialty
- Parenteral & Enteral Nutrition Supplies (DME)Suppliers
- Organization subpart
- No
- Authorized official
- Michael Lebovics, Vice President(732) 363-3001
- License
- 1509850 (NJ)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
585 Prospect St
Unit 304
Lakewood, NJ 08701-5073
Phone: (732) 363-3001
Street-level locationGet directions
Mailing address
585 Prospect St
Lakewood, NJ 08701-5073
Registry dates
- Enumerated
- 2009-09-29
- Last updated
- 2024-05-20
- Certified
- 2024-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.