=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386803419
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ATLANTIS COMMUNITY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2008
-----------------------------------------------------
Last Update Date | 06/04/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 S CHEROKEE ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80223-1836
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-733-9324
-----------------------------------------------------
Fax | 303-733-6211
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 S CHEROKEE ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80223-1836
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-733-9324
-----------------------------------------------------
Fax | 303-733-6211
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR DME
-----------------------------------------------------
Name | MR. DAVID HAYS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 303-744-8167
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------