MEDICARE: ATLAS MEDICAL SUPPLY 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	291U00000X	Clinical Medical Laboratory
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1093696742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLAS MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	2640 OLD DENTON RD STE 240
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-5453
Country	:	US
Telephone Number	:	469-758-0055
Fax Number	:

Provider Business Practice Location Address
First Line	:	2640 OLD DENTON RD STE 240
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-5453
Country	:	US
Telephone Number	:	469-758-0055
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	INFANT CORONADO
Credential	:
Telephone Number	:	469-758-0055

Provider Enumeration Date	:	09/09/2025
Last Update Date	:	01/21/2026

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Directions to “ATLAS MEDICAL SUPPLY LLC ” Practice Location

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