Provider Demographics
NPI:1508891698
Name:ATLANTIC MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:ATLANTIC MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRATALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-791-6442
Mailing Address - Street 1:PO BOX 198870
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8870
Mailing Address - Country:US
Mailing Address - Phone:910-791-6442
Mailing Address - Fax:866-278-1293
Practice Address - Street 1:4536 TECHNOLOGY DR
Practice Address - Street 2:SUITE 4
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-2172
Practice Address - Country:US
Practice Address - Phone:910-791-6442
Practice Address - Fax:866-278-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704803Medicaid
NC7704803Medicaid