Organization
ATLANTIC PH LLC
Active
Other names
ATLANTIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NIRMIN NASR (MANAGER)
(321) 514-4694
Entity
Organization
Contact information
Practice address
1525 S WICKHAM RD, MELBOURNE, FL 32904-3540
(321) 821-4998
(321) 821-4971
Mailing address
3278 LAMANGA DR, MELBOURNE, FL 32940-8524
(321) 514-4694
(321) 821-4971
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH31134
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024459300
—
FL
01
—
2175640
PK
—
Enumeration date
01/26/2018
Last updated
09/19/2025
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