Provider Demographics
NPI:1912236514
Name:ATLAS MEDICAL SUPPLIES AND EQUIPMENT, INC
Entity Type:Organization
Organization Name:ATLAS MEDICAL SUPPLIES AND EQUIPMENT, INC
Other - Org Name:ATLAS DURABLE MEDICAL EQUIPMENT, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCBETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-515-7300
Mailing Address - Street 1:320 SUPERIOR AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-2716
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:320 SUPERIOR AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-2716
Practice Address - Country:US
Practice Address - Phone:949-515-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MADISON BURBANK MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39618332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies