Provider Demographics
NPI:1548395502
Name:ATS UNIVERSAL LLC
Entity Type:Organization
Organization Name:ATS UNIVERSAL LLC
Other - Org Name:ATS HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPPORT SERVICES SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-398-9098
Mailing Address - Street 1:6820 SOUTHPOINT PKWY
Mailing Address - Street 2:STE 3
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6276
Mailing Address - Country:US
Mailing Address - Phone:900-398-9098
Mailing Address - Fax:904-346-0089
Practice Address - Street 1:11111 CARMEL COMMONS BLVD
Practice Address - Street 2:STE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-5319
Practice Address - Country:US
Practice Address - Phone:980-235-2760
Practice Address - Fax:704-716-2257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1030251E00000X
FL20158096251E00000X
FL251E00000X, 251E00000X, 251E00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408750Medicaid
FL287841OtherAMERIGROUP
NC6600422Medicaid
FL299191OtherAVMED
FL60-01007OtherUNITED HEALTHCARE