Provider Demographics
NPI:1720234677
Name:ANATOMIC HEALTH LLC
Entity Type:Organization
Organization Name:ANATOMIC HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:TOBIAS
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:954-292-8657
Mailing Address - Street 1:6750 N ANDREWS AVE
Mailing Address - Street 2:SUITE 200, #2125
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-2173
Mailing Address - Country:US
Mailing Address - Phone:954-489-1121
Mailing Address - Fax:954-772-7801
Practice Address - Street 1:6750 N ANDREWS AVE
Practice Address - Street 2:SUITE 200, #2125
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2173
Practice Address - Country:US
Practice Address - Phone:954-489-1121
Practice Address - Fax:954-772-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment