Organization
ATLANTIC MEDICAL, LLC
Active
Other names
Canyon Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
JACI TRON (OFFICE MANAGER)
(662) 449-3200
Entity
Organization
Contact information
Practice address
1068 THOUSAND OAKS DR, SUITE B, HERNANDO, MS 38632-7742
(662) 449-3200
(888) 891-3929
Mailing address
1785 NONCONNAH BLVD, SUITE 107, MEMPHIS, TN 38132-2104
(662) 449-3200
(888) 891-3929
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
F11493
MS
3336M0002X
Mail Order Pharmacy
Primary
F12216
MS
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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