Provider Demographics
NPI:1326789587
Name:ATLANTIC MEDICAL TRANSPORT, LLC
Entity Type:Organization
Organization Name:ATLANTIC MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:NELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-812-3947
Mailing Address - Street 1:25 DUNVALE RD APT 456
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2693
Mailing Address - Country:US
Mailing Address - Phone:443-812-3947
Mailing Address - Fax:
Practice Address - Street 1:25 DUNVALE RD APT 456
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2693
Practice Address - Country:US
Practice Address - Phone:443-812-3947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-03
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport