1881703155 NPI number — SKY IMAGING LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881703155 NPI number — SKY IMAGING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SKY IMAGING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
QOURSAI OF NEW PORT RICHEY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881703155
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4807 US HIGHWAY 19
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
NEW PORT RICHEY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34652-4263
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-848-2727
Provider Business Mailing Address Fax Number:
727-264-4000

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4807 US HIGHWAY 19
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
NEW PORT RICHEY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34652-4263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-848-2727
Provider Business Practice Location Address Fax Number:
727-264-4000
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GALBATO
Authorized Official First Name:
JODI
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PATIENT ACCOUNTS
Authorized Official Telephone Number:
954-577-5836

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  HCC6345 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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