Provider Demographics
NPI:1679066542
Name:ATLANTIC DME LLC
Entity Type:Organization
Organization Name:ATLANTIC DME LLC
Other - Org Name:ATLANTIC MEDICAL GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANUP
Authorized Official - Middle Name:
Authorized Official - Last Name:SALGIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-456-3487
Mailing Address - Street 1:3501 LESH ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-4376
Mailing Address - Country:US
Mailing Address - Phone:330-456-3487
Mailing Address - Fax:330-456-3895
Practice Address - Street 1:3501 LESH ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705
Practice Address - Country:US
Practice Address - Phone:330-456-3487
Practice Address - Fax:330-456-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies