Healthcare Provider Details
I. General information
NPI: 1013109099
Provider Name (Legal Business Name): ATI HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2007
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1510 ROCK SPRING RD STE C
FOREST HILL MD
21050-2851
US
IV. Provider business mailing address
790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US
V. Phone/Fax
- Phone: 410-420-3619
- Fax: 410-420-3620
- Phone: 630-296-2222
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LYNN
MCGIVERN
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 630-296-2222