Provider Demographics
NPI:1497535561
Name:BLUESKYMT
Entity Type:Organization
Organization Name:BLUESKYMT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-729-9999
Mailing Address - Street 1:3557 BRADSHAW RD STE 2C
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-3373
Mailing Address - Country:US
Mailing Address - Phone:916-729-9999
Mailing Address - Fax:
Practice Address - Street 1:3557 BRADSHAW RD STE 2C
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3373
Practice Address - Country:US
Practice Address - Phone:916-729-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)