Provider Demographics
NPI:1821451980
Name:SKYLAND PROSTHETICS & ORTHOTICS, INC
Entity Type:Organization
Organization Name:SKYLAND PROSTHETICS & ORTHOTICS, INC
Other - Org Name:SKYLAND PROSTHETICS, SYLVA
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRONK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-684-1644
Mailing Address - Street 1:3845 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-8241
Mailing Address - Country:US
Mailing Address - Phone:828-631-1379
Mailing Address - Fax:828-631-3622
Practice Address - Street 1:583 ASHEVILLE HWY
Practice Address - Street 2:SUITE 3
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-5101
Practice Address - Country:US
Practice Address - Phone:828-631-1379
Practice Address - Fax:828-631-3622
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SKYLAND PROSTHETICS & ORTHOTICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-05
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 335E00000X
NC332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7700057Medicaid
NC7700057Medicaid