Provider Demographics
NPI:1821566258
Name:BLUE SKY HEALTH, INC.
Entity Type:Organization
Organization Name:BLUE SKY HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-560-2353
Mailing Address - Street 1:5932 PINE GROVE TRL STE 108
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3503
Mailing Address - Country:US
Mailing Address - Phone:423-710-2041
Mailing Address - Fax:
Practice Address - Street 1:5932 PINE GROVE TRL STE 108
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3503
Practice Address - Country:US
Practice Address - Phone:423-710-2041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-03
Last Update Date:2018-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies