Healthcare Provider Details

I. General information

NPI: 1962330332
Provider Name (Legal Business Name): ATRACK MED SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2232 DELL RANGE BLVD STE 3031554
CHEYENNE WY
82009-4941
US

IV. Provider business mailing address

2232 DELL RANGE BLVD STE 3031554
CHEYENNE WY
82009-4941
US

V. Phone/Fax

Practice location:
  • Phone: 561-492-9199
  • Fax:
Mailing address:
  • Phone: 561-492-9199
  • 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: JORDAN PRESLEY
Title or Position: CEO
Credential:
Phone: 561-492-9199