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General NPI Number Information
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NPI Number | 1932481629
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Entity Type | Organization
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Legal Business Name | SKYLINE EMS INC.
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Dates
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Enumeration Date | 09/19/2011
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Last Update Date | 01/23/2013
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Provider Practice Location Address
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Address Line | 1908 S MAIN ST
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City | MCALLEN
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State | TX
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Zip | 78503-5414
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Country | US
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Telephone | 956-240-4448
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Fax | 267-381-4496
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Provider Business Mailing Address
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Address Line | 310 E MAIN AVE STE 213
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City | ALTON
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State | TX
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Zip | 78573-6872
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Country | US
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Telephone | 956-240-4448
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Fax | 267-381-4496
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JUAN FRANCISCO CORDERO JR.
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Credential | ECA
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Telephone | 956-240-4448
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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 | 1000723
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License Number State | TX
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