Atlantic Medical, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

F12216 Issued in MS

Legal business name

ATLANTIC MEDICAL, LLC

Doing business as

A1 Pharmacy Services

Practice address

915 Ferncliff CV Ste 1a
Southaven, MS 38671-2420

Phone

(855) 722-8526

Fax

(855) 239-6226

NPI assigned

Oct 12, 2012

Last updated

Sep 30, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Justin Ferreira

Title

Managing Member

Phone

(855) 722-8526

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• A1 Pharmacy Services Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Atlantic Medical LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Atlantic Medical, LLC

  dba Canyon Healthcare

  • Mail Order Pharmacy
  • Hernando, MS
  • NPI 1588080881
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Lincare Inc.

  • Durable Medical Equipment & Medical Supplies
  • Naples, FL
  • NPI 1003978834

  Member Of

  NPD member

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• A1 Diabetes & Medical Supply, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Eustis, FL
  • NPI 1366436107

  Member Of

  NPD member
• A1 Diabetes & Medical Supply, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Memphis, TN
  • NPI 1992799787

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1356693436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 FERNCLIFF CV STE 1A",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712420",
            "telephone_number": "855-722-8526",
            "fax_number": "855-239-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 FERNCLIFF CV STE 1A",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712420",
            "telephone_number": "855-722-8526",
            "fax_number": "855-239-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-12",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "FERREIRA",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "855-722-8526",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "F11493",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "F12216",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "MS",
            "license": "F12216",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08527840",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A1 Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A1 Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Armstrong
• Tabitha Flowers Arrington, NURSE PRACTITIONER
• Karen Ashabranner
• Anthony Alan Ashbrook, RPH
• Linda Awung Asongayi
• Vicenda Augustin
• Jennah Suzuko Avery-Morin
• Hany Imad Awad, MD, MPH
• Mariam Sherif Awad
• Axon Surgical Center, PLLC

• Community/Retail Pharmacy in Southaven, MS
• Providers in Southaven, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.