Healthcare Provider Details

I. General information

NPI: 1750576484
Provider Name (Legal Business Name): SKYLINE MEDICAL EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 S MAYO TRL
PAINTSVILLE KY
41240-1384
US

IV. Provider business mailing address

818 S MAYO TRL
PAINTSVILLE KY
41240-1384
US

V. Phone/Fax

Practice location:
  • Phone: 606-789-7730
  • Fax: 606-789-1028
Mailing address:
  • Phone: 606-789-7730
  • Fax: 606-789-1028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. PATRICIA NELSON
Title or Position: ADMIN
Credential:
Phone: 606-789-7730