MEDICARE: ATTICUS GROUP LLC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	12242/2.1	MS
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	12242/2.1	MS
3	333600000X	Pharmacy	06155081	MS
4	3336C0004X	Compounding Pharmacy	12242/2.1	MS
5	3336S0011X	Specialty Pharmacy
6	3336H0001X	Home Infusion Therapy Pharmacy	12242/2.1	MS

Other Identifiers

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

General Provider Information

NPI Number	:	1679910269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATTICUS GROUP LLC

Provider Business Mailing Address
First Line	:	159 FOUNTAINS BLVD
Second Line	:	SUITE B
City	:	MADISON
State	:	MS
Zip	:	39110-6344
Country	:	US
Telephone Number	:	601-859-8200
Fax Number	:	601-859-1057

Provider Business Practice Location Address
First Line	:	159 FOUNTAINS BLVD
Second Line	:	SUITE B
City	:	MADISON
State	:	MS
Zip	:	39110-6344
Country	:	US
Telephone Number	:	601-859-8200
Fax Number	:	601-859-1057

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN DOUGLAS HEGI
Credential	:
Telephone Number	:	769-798-7748

Provider Enumeration Date	:	05/23/2013
Last Update Date	:	12/02/2024

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Directions to “ATTICUS GROUP LLC ” Practice Location

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