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NPI Code Detail

MEDICARE: SKILLZRUS LLC

MEDICARE: SKILLZRUS 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
1174200000XMeals Provider
2310400000XAssisted Living Facility
3332B00000XDurable Medical Equipment & Medical Supplies
4332BC3200XCustomized Equipment (DME)
5335E00000XProsthetic/Orthotic Supplier
6251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11174156012OTHERPANPI NUMBER

General Provider Information

NPI Number : 1912593500
Entity Type Code : Organization
Provider Name (Legal Business Name) : SKILLZRUS LLC
Provider Business Mailing Address
First Line : 2218 N MARKET ST
Second Line :
City : WILMINGTON
State : DE
Zip : 19802-4248
Country : US
Telephone Number : 267-234-3333
Fax Number :
Provider Business Practice Location Address
First Line : 2218 N MARKET ST
Second Line :
City : WILMINGTON
State : DE
Zip : 19802-4248
Country : US
Telephone Number : 267-234-3333
Fax Number :
Authorized Official
Title or Position : CEO
Name : SADE DAVIS
Credential :
Telephone Number : 267-234-3333
Provider Enumeration Date : 12/17/2020
Last Update Date : 04/27/2022

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Directions to “SKILLZRUS LLC ” Practice Location

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