Healthcare Provider Details

I. General information

NPI: 1902943012
Provider Name (Legal Business Name): SKYLAND MRI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 10/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1998 HENDERSON HIGHWAY
ASHEVILLE NC
28803
US

IV. Provider business mailing address

PO BOX 580
FLETCHER NC
28732-0580
US

V. Phone/Fax

Practice location:
  • Phone: 828-687-8141
  • Fax: 828-687-8142
Mailing address:
  • Phone: 828-684-2420
  • Fax: 828-687-0729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLY PETTIJOHN
Title or Position: TREASURER
Credential:
Phone: 828-684-2420