Provider Demographics
NPI:1013397306
Name:ATLAS MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:ATLAS MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:IFEANYI
Authorized Official - Last Name:OGBOLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-342-8888
Mailing Address - Street 1:11615 FOREST CENTRAL DR
Mailing Address - Street 2:SUITE 321
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3921
Mailing Address - Country:US
Mailing Address - Phone:214-342-8888
Mailing Address - Fax:214-342-9999
Practice Address - Street 1:11615 FOREST CENTRAL DR
Practice Address - Street 2:SUITE 321
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3921
Practice Address - Country:US
Practice Address - Phone:214-342-8888
Practice Address - Fax:214-342-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000575332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies