Provider Demographics
NPI:1801594593
Name:ATLAS MEDICAL TRANSPORT
Entity type:Organization
Organization Name:ATLAS MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIALYSIS NURSE
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:AYISI
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:301-437-4101
Mailing Address - Street 1:7134 DEEP FALLS WAY
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-7090
Mailing Address - Country:US
Mailing Address - Phone:301-437-4101
Mailing Address - Fax:
Practice Address - Street 1:7134 DEEP FALLS WAY
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-7090
Practice Address - Country:US
Practice Address - Phone:301-437-4101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5000000007768764OtherNONE