Provider Demographics
NPI:1417728775
Name:SKY ORTHOPEDIC SOLUTIONS
Entity Type:Organization
Organization Name:SKY ORTHOPEDIC SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYNOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-903-8148
Mailing Address - Street 1:802 AZALEA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-5371
Mailing Address - Country:US
Mailing Address - Phone:520-903-8148
Mailing Address - Fax:
Practice Address - Street 1:802 AZALEA AVE
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-5371
Practice Address - Country:US
Practice Address - Phone:520-903-8148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies