MEDICARE: SKYMED LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416A0800X	Air Ambulance	1000700	TX

General Provider Information

NPI Number	:	1396053138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKYMED LLC.

Provider Business Mailing Address
First Line	:	10830 CRAIGHEAD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-5804
Country	:	US
Telephone Number	:	800-424-9000
Fax Number	:	800-424-9000

Provider Business Practice Location Address
First Line	:	10830 CRAIGHEAD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-5804
Country	:	US
Telephone Number	:	800-424-9000
Fax Number	:	800-424-9000

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. SHARON AMOS
Credential	:
Telephone Number	:	832-265-5666

Provider Enumeration Date	:	09/14/2010
Last Update Date	:	08/05/2014

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