MEDICARE: OKLAHOMA SKYNET, INC

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1467200477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OKLAHOMA SKYNET, INC

Provider Business Mailing Address
First Line	:	1117 S DOUGLAS BLVD STE F
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5265
Country	:	US
Telephone Number	:	405-259-9478
Fax Number	:

Provider Business Practice Location Address
First Line	:	1117 S DOUGLAS BLVD STE F
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5265
Country	:	US
Telephone Number	:	405-259-9478
Fax Number	:

Authorized Official
Title or Position	:	SR. MANAGER, SPECIAL PROGRAMS
Name	:	MRS. KATHERINE YOUNG
Credential	:
Telephone Number	:	405-455-8563

Provider Enumeration Date	:	05/07/2024
Last Update Date	:	05/07/2024

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