MEDICARE: SKATT ENTERPRISES, 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1467911842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKATT ENTERPRISES, LLC

Provider Business Mailing Address
First Line	:	20133 EASTWOOD DR
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-5353
Country	:	US
Telephone Number	:	225-405-7944
Fax Number	:

Provider Business Practice Location Address
First Line	:	20133 EASTWOOD DR
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-5353
Country	:	US
Telephone Number	:	225-405-7944
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. SAMUEL FRANKLIN PATTERSON III
Credential	:
Telephone Number	:	225-405-7944

Provider Enumeration Date	:	03/15/2019
Last Update Date	:	03/15/2019

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