Healthcare Provider Details

I. General information

NPI: 1306759212
Provider Name (Legal Business Name): ELMO SKY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 S DOBSON RD STE 114
MESA AZ
85202-5656
US

IV. Provider business mailing address

16025 S 50TH ST APT 2162
PHOENIX AZ
85048-5020
US

V. Phone/Fax

Practice location:
  • Phone: 520-858-5287
  • Fax:
Mailing address:
  • Phone: 520-858-5287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. ELMOKARAM MOHAMMED
Title or Position: OWNER
Credential:
Phone: 520-858-5287