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NPI Code Detail

MEDICARE: ATLANTIC MEDICAL INC

MEDICARE: ATLANTIC MEDICAL INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2332BX2000XOxygen Equipment & Supplies (DME)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2181047OTHERVAANTHEM

General Provider Information

NPI Number : 1356435143
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATLANTIC MEDICAL INC
Provider Business Mailing Address
First Line : 3325 BARTLETT BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32811-6428
Country : US
Telephone Number : 407-206-0040
Fax Number : 407-206-0010
Provider Business Practice Location Address
First Line : 532 WILBORN AVE
Second Line :
City : SOUTH BOSTON
State : VA
Zip : 24592-3120
Country : US
Telephone Number : 434-572-1853
Fax Number : 434-572-1934
Authorized Official
Title or Position : CEO
Name : STEPHE GRIGGS
Credential :
Telephone Number : 407-206-0040
Provider Enumeration Date : 10/03/2006
Last Update Date : 03/12/2018

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