Atlantic PH LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH31134 Issued in FL

Legal business name

ATLANTIC PH LLC

Practice address

1525 S Wickham Rd
Melbourne, FL 32904-3540

Phone

(321) 821-4998

Fax

(321) 821-4971

NPI assigned

Jan 26, 2018

Organization subpart

No

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

Authorized official

Name

Nirmin NasrNPI 1942548037

Title

Manager

Phone

(321) 514-4694

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ATLANTIC PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nirmin Maged Nasr

  • Pharmacist
  • Melbourne, FL
  • NPI 1942548037
  NPD (past) Authorized official

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1477051217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3278 LAMANGA DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408524",
            "telephone_number": "321-514-4694",
            "fax_number": "321-821-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 S WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043540",
            "telephone_number": "321-821-4998",
            "fax_number": "321-821-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC PH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-26",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "NASR",
        "authorized_official_first_name": "NIRMIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "321-514-4694"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH31134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175640",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024459300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATLANTIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ATLANTIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.