Provider Demographics
NPI:1164672531
Name:ATOMIC CORPORATION
Entity Type:Organization
Organization Name:ATOMIC CORPORATION
Other - Org Name:ROCK SPRINGS REGIONAL AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-362-9500
Mailing Address - Street 1:PO BOX 2400
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82902-2400
Mailing Address - Country:US
Mailing Address - Phone:307-362-9500
Mailing Address - Fax:307-362-4339
Practice Address - Street 1:820 POWER HOUSE RD
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5494
Practice Address - Country:US
Practice Address - Phone:307-362-9500
Practice Address - Fax:307-362-4339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY141341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
W22660Medicare PIN