Organization
ATLASMEDART LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTON ARTAMASAV (CHIEF EXECUTIVE OFFICER)
(502) 630-1996
Entity
Organization
Contact information
Practice address
310 E BROADWAY STE 120, LOUISVILLE, KY 40202-1745
(502) 630-1995
(502) 708-1599
Mailing address
310 E BROADWAY STE 120, LOUISVILLE, KY 40202-1745
(502) 708-1599
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263672
KY STATE LICENSE
KY
01
—
69001687A
IN STATE LICENSE
IN
05
—
7100684010
—
KY
Enumeration date
04/08/2020
Last updated
12/03/2021
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