Provider Demographics
NPI:1356897441
Name:ATLANTIX MEDICAL SUPPLIES INC.
Entity type:Organization
Organization Name:ATLANTIX MEDICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:OBILO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-395-9655
Mailing Address - Street 1:2806 CODDINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5925
Mailing Address - Country:US
Mailing Address - Phone:347-657-0347
Mailing Address - Fax:347-657-0347
Practice Address - Street 1:2806 CODDINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5925
Practice Address - Country:US
Practice Address - Phone:347-657-0347
Practice Address - Fax:347-657-0347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment