Provider Demographics
NPI:1861088239
Name:ATLANTICMD PHARMACY
Entity type:Organization
Organization Name:ATLANTICMD PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FOUAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-380-4903
Mailing Address - Street 1:6100 BLACK HORSE PIKE STE A5
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-9753
Mailing Address - Country:US
Mailing Address - Phone:609-380-4903
Mailing Address - Fax:609-380-4902
Practice Address - Street 1:6100 BLACK HORSE PIKE STE A5
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08234-9753
Practice Address - Country:US
Practice Address - Phone:609-380-4903
Practice Address - Fax:609-380-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy