Healthcare Provider Details

I. General information

NPI: 1841471786
Provider Name (Legal Business Name): ATLANTIC UNIFORMS AND MEDICAL SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SOUTH MAIN ST.
LITTLETON NC
27850
US

IV. Provider business mailing address

100 SOUTH MAIN ST.
LITTLETON NC
27850
US

V. Phone/Fax

Practice location:
  • Phone: 252-586-0111
  • Fax: 252-586-0115
Mailing address:
  • Phone: 252-586-0111
  • Fax: 252-586-0115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. LINWOOD EARL WATERS
Title or Position: CO-OWNER
Credential:
Phone: 252-586-0111