Provider Demographics
NPI:1013744960
Name:SKY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:SKY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDULLAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-833-8342
Mailing Address - Street 1:9990 FAIRFAX BLVD STE 560
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-1743
Mailing Address - Country:US
Mailing Address - Phone:571-833-8342
Mailing Address - Fax:
Practice Address - Street 1:9990 FAIRFAX BLVD STE 560
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-1743
Practice Address - Country:US
Practice Address - Phone:571-833-8342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health