MEDICARE: SKYY TRANSPORTATION 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	:	1902306160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKYY TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	9415 PALM ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-1923
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9415 PALM ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-1923
Country	:	US
Telephone Number	:	504-388-9218
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAVIS BROWN
Credential	:
Telephone Number	:	504-388-9218

Provider Enumeration Date	:	02/14/2018
Last Update Date	:	02/14/2018

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Directions to “SKYY TRANSPORTATION LLC ” Practice Location

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