Healthcare Provider Details

I. General information

NPI: 1114881620
Provider Name (Legal Business Name): ATLAS MEDICAL SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SCHELL LN STE 305
PHOENIXVILLE PA
19460-1187
US

IV. Provider business mailing address

300 SCHELL LN STE 305
PHOENIXVILLE PA
19460-1187
US

V. Phone/Fax

Practice location:
  • Phone: 484-390-0378
  • Fax:
Mailing address:
  • Phone: 484-390-0378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN M GVODAS JR.
Title or Position: CEO/MANAGING MEMBER
Credential:
Phone: 484-390-0378