ATLANTIC HLTH RESOURCES INC — NPI 1154475507 (Licensed & Credentialed Suppliers — Pharmacy, Specialty Pharmacy in DAVIDSON, NC)

CMS-1500 Box 24J / 33a • NPI

1154475507

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

3336S0011X (CMS 58)

Licensed & Credentialed Suppliers — Pharmacy, Specialty Pharmacy

Box 32 Service Location & ZIP+4

582 DAVIDSON GATEWAY DR, DAVIDSON, NC, 28036-7009

✓ 9-Digit EDI 837 ZIP+4 (28036-7009)

Practice Phone & Referral Fax

(704) 895-6527

Fax: (704) 892-6040

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1154475507 (ATLANTIC HLTH RESOURCES INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1154475507` (NPI-2 Organization / Facility)
Provider / Legal Name	ATLANTIC HLTH RESOURCES INC
Plain-English Specialty	Licensed & Credentialed Suppliers — Pharmacy, Specialty Pharmacy NUCC Code: `3336S0011X` (Pharmacy, Specialty Pharmacy)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	582 DAVIDSON GATEWAY DR, DAVIDSON, NC, 28036-7009
Practice Telephone / Fax	Tel: (704) 895-6527 \| Fax: (704) 892-6040
Administrative Mailing Address	PO BOX 1405, DAVIDSON, NC, 28036-1405
Enumeration & Last Sync	Enumerated: 2007-01-23 \| CMS Record Updated: 2010-05-28
Authorized Official	CRAIG BLANEY (PIC)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

582 DAVIDSON GATEWAY DR, DAVIDSON, NC, 28036-7009

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Plain-English Taxonomy & CMS Crosswalk (3336S0011X)

What Does Taxonomy Code 3336S0011X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3336S0011X translates to:
"Licensed & Credentialed Suppliers — Pharmacy, Specialty Pharmacy"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 58 (Medical Supply Company with Pharmacist) • CMS Code A5 (Pharmacy)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Pharmacy, Specialty Pharmacy for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ATLANTIC HLTH RESOURCES INC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`3336C0003X` — Pharmacy, Community/Retail Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy	State: N/A \| License: `Verified` \| Primary: Secondary
`3336H0001X` — Pharmacy, Home Infusion Therapy Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy, Home Infusion Therapy Pharmacy	State: N/A \| License: `Verified` \| Primary: Secondary
`3336S0011X` — Pharmacy, Specialty Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy, Specialty Pharmacy	State: NC \| License: `09263` \| Primary: Yes (Primary)

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ATLANTIC HLTH RESOURCES INC (NPI #1154475507)