Provider Demographics
NPI:1063667418
Name:ATLANTIC MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:ATLANTIC MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:ENZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:207-992-6741
Mailing Address - Street 1:5 BARTERS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:KITTERY POINT
Mailing Address - State:ME
Mailing Address - Zip Code:03905-5611
Mailing Address - Country:US
Mailing Address - Phone:207-992-6741
Mailing Address - Fax:
Practice Address - Street 1:5 BARTERS CREEK RD
Practice Address - Street 2:
Practice Address - City:KITTERY POINT
Practice Address - State:ME
Practice Address - Zip Code:03905-5611
Practice Address - Country:US
Practice Address - Phone:207-992-6741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-27
Last Update Date:2008-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies