Provider Demographics
NPI:1831836857
Name:ARTHEON MEDICAL LLC
Entity type:Organization
Organization Name:ARTHEON MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLARIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-367-1110
Mailing Address - Street 1:1107 E JACKSON ST # 206
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4115
Mailing Address - Country:US
Mailing Address - Phone:813-367-1110
Mailing Address - Fax:
Practice Address - Street 1:1107 E JACKSON ST # 206
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4115
Practice Address - Country:US
Practice Address - Phone:813-367-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies