Provider Demographics
NPI:1659160034
Name:ATLAS MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:ATLAS MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NEZAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ILAIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-500-2258
Mailing Address - Street 1:701 B ST STE 1570
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-8153
Mailing Address - Country:US
Mailing Address - Phone:951-380-2181
Mailing Address - Fax:
Practice Address - Street 1:701 B ST STE 1570
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-8153
Practice Address - Country:US
Practice Address - Phone:951-380-2181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies