Provider Demographics
NPI:1801840079
Name:ATLANTIC PHARMACY SERVICES INC
Entity Type:Organization
Organization Name:ATLANTIC PHARMACY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EMERSON
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-666-8711
Mailing Address - Street 1:4908 SW 72ND AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5548
Mailing Address - Country:US
Mailing Address - Phone:305-666-8711
Mailing Address - Fax:305-666-9117
Practice Address - Street 1:4908 SW 72ND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5548
Practice Address - Country:US
Practice Address - Phone:305-666-8711
Practice Address - Fax:305-666-9117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH197143336C0003X
FLPH 231543336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1006510OtherNABP
FL1006510OtherNABP
FL1006510OtherNABP