Organization
ATLANTIC MEDICAL, LLC
Active
Other names
A1 Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN FERREIRA (MANAGING MEMBER)
(855) 722-8526
Entity
Organization
Contact information
Practice address
915 FERNCLIFF CV STE 1A, SOUTHAVEN, MS 38671-2420
(855) 722-8526
(855) 239-6226
Mailing address
915 FERNCLIFF CV STE 1A, SOUTHAVEN, MS 38671-2420
(855) 722-8526
(855) 239-6226
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
F11493
MS
3336C0003X
Community/Retail Pharmacy
Primary
F12216
MS
3336M0002X
Mail Order Pharmacy
F12216
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08527840
—
MS
Enumeration date
10/12/2012
Last updated
09/30/2022
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