Provider Demographics
NPI:1689050502
Name:SKY LIFE EMS INC
Entity Type:Organization
Organization Name:SKY LIFE EMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISSIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MGENDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-210-2694
Mailing Address - Street 1:2385 WALL ST SE
Mailing Address - Street 2:SUITE 208 B
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2187
Mailing Address - Country:US
Mailing Address - Phone:678-210-2694
Mailing Address - Fax:678-964-2338
Practice Address - Street 1:2385 WALL ST SE
Practice Address - Street 2:SUITE 208 B
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2187
Practice Address - Country:US
Practice Address - Phone:678-210-2694
Practice Address - Fax:678-964-2338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport