Provider Demographics
NPI:1326574237
Name:SKYCADE MED CORPORATION
Entity Type:Organization
Organization Name:SKYCADE MED CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEUNDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-632-6820
Mailing Address - Street 1:530 COPELAND DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-5062
Mailing Address - Country:US
Mailing Address - Phone:469-334-9492
Mailing Address - Fax:
Practice Address - Street 1:530 COPELAND DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-5062
Practice Address - Country:US
Practice Address - Phone:469-334-9492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health