MEDICARE: ATLANTIC VENTURES LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1790568970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC VENTURES LLC.

Provider Business Mailing Address
First Line	:	1308 E. COLORADO BLVD
Second Line	:	UNIT #3132
City	:	PASADENA
State	:	CA
Zip	:	91106
Country	:	US
Telephone Number	:	626-429-3001
Fax Number	:

Provider Business Practice Location Address
First Line	:	1308 E. COLORADO BLVD
Second Line	:	UNIT #3132
City	:	PASADENA
State	:	CA
Zip	:	91106
Country	:	US
Telephone Number	:	626-310-8544
Fax Number	:

Authorized Official
Title or Position	:	C.E.O.
Name	:	MR. EMMANUEL AKINDELE ILUPEJU
Credential	:
Telephone Number	:	626-429-3001

Provider Enumeration Date	:	08/14/2023
Last Update Date	:	08/14/2023

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Directions to “ATLANTIC VENTURES LLC. ” Practice Location

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