Provider Demographics
NPI:1386803419
Name:ATLANTIS COMMUNITY INC
Entity type:Organization
Organization Name:ATLANTIS COMMUNITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR DME
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-744-8167
Mailing Address - Street 1:201 S CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-1836
Mailing Address - Country:US
Mailing Address - Phone:303-733-9324
Mailing Address - Fax:303-733-6211
Practice Address - Street 1:201 S CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-1836
Practice Address - Country:US
Practice Address - Phone:303-733-9324
Practice Address - Fax:303-733-6211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08002529Medicaid