MEDICARE: SKY HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1982282539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKY HOME HEALTH INC.

Provider Business Mailing Address
First Line	:	7610 AUBURN BLVD STE 5
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610-2200
Country	:	US
Telephone Number	:	916-530-2112
Fax Number	:	916-530-2113

Provider Business Practice Location Address
First Line	:	7610 AUBURN BLVD STE 5
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610-2200
Country	:	US
Telephone Number	:	916-530-2112
Fax Number	:	916-530-2113

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. PERCHUI ANNIE DEMIRCHYAN
Credential	:
Telephone Number	:	916-530-2112

Provider Enumeration Date	:	04/01/2021
Last Update Date	:	04/01/2021

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