Healthcare Provider Details
I. General information
NPI: 1043225626
Provider Name (Legal Business Name): SKORO ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2006
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
804 SUMMER PARK DR STE 400
STAFFORD TX
77477-6061
US
IV. Provider business mailing address
220 W GERMANTOWN PIKE STE 250
PLYMOUTH MEETING PA
19462-1437
US
V. Phone/Fax
- Phone: 281-969-8800
- Fax: 281-969-7126
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 0070824 |
| License Number State | TX |
VIII. Authorized Official
Name:
STEPHEN
GRIGGS
Title or Position: CEO
Credential:
Phone: 407-206-0040