Healthcare Provider Details

I. General information

NPI: 1437060910
Provider Name (Legal Business Name): SKM ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11424 CAMINO RUIZ
SAN DIEGO CA
92126-1340
US

IV. Provider business mailing address

509 TWIN OAK CT
HIGH POINT NC
27260-6940
US

V. Phone/Fax

Practice location:
  • Phone: 314-639-9213
  • Fax:
Mailing address:
  • Phone:
  • 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: SHARON KETTERINGHAM
Title or Position: MANAGER
Credential:
Phone: 314-639-9213