Provider Demographics
NPI:1154349157
Name:ATLANTIC HOME MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:ATLANTIC HOME MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-295-7191
Mailing Address - Street 1:PO BOX 1723
Mailing Address - Street 2:
Mailing Address - City:ONSET
Mailing Address - State:MA
Mailing Address - Zip Code:02558-1723
Mailing Address - Country:US
Mailing Address - Phone:508-295-7191
Mailing Address - Fax:
Practice Address - Street 1:3105 CRANBERRY HIGHWAY
Practice Address - Street 2:
Practice Address - City:E.WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02538
Practice Address - Country:US
Practice Address - Phone:508-295-7191
Practice Address - Fax:508-295-5541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition