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General NPI Number Information
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NPI Number | 1487837241
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Entity Type | Organization
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Legal Business Name | SKMP ENTERPRISES, INC.
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 279 NOBLE AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06608-2210
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Country | US
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Telephone | 203-637-2351
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Fax | 203-698-2150
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Provider Business Mailing Address
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Address Line | PO BOX 188
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City | NORTH HAVEN
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State | CT
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Zip | 06473-0188
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Country | US
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Telephone | 203-637-2351
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Fax | 203-698-2150
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Authorized Official
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Title or Position | VP / TREASURER
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Name | MR. MARK JOSEPH PANICO
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Credential | MBA
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Telephone | 203-996-2208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | L015P2
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License Number State | CT
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