Provider Demographics
NPI:1467270603
Name:ATLAS MEDIVAC LLC
Entity type:Organization
Organization Name:ATLAS MEDIVAC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENERIO
Authorized Official - Middle Name:HERNANDEZ
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-483-0450
Mailing Address - Street 1:RAN-CARE BLDG. 761 SOUTH MARINE CORPS DR.
Mailing Address - Street 2:CBU-107
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913
Mailing Address - Country:US
Mailing Address - Phone:671-483-4601
Mailing Address - Fax:
Practice Address - Street 1:RAN-CARE COMMERCIAL BLDG.
Practice Address - Street 2:761 SOUTH MARINE CORPS DR. UNIT A-10
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-483-0450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport