Provider Demographics
NPI:1891156014
Name:SKYVISION CAM
Entity Type:Organization
Organization Name:SKYVISION CAM
Other - Org Name:APT HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:RILE
Authorized Official - Last Name:PANONCILLO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:765-760-4729
Mailing Address - Street 1:7804 W ADARE DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-9434
Mailing Address - Country:US
Mailing Address - Phone:765-760-4729
Mailing Address - Fax:
Practice Address - Street 1:7804 W ADARE DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-9434
Practice Address - Country:US
Practice Address - Phone:765-760-4729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty