Provider Demographics
NPI:1497571723
Name:SKY BLU MEDICAL TRANSPORTATION SERVICE INC
Entity type:Organization
Organization Name:SKY BLU MEDICAL TRANSPORTATION SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIDEN BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-835-4646
Mailing Address - Street 1:509 MARKET ST APT 1001
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-5097
Mailing Address - Country:US
Mailing Address - Phone:248-835-4646
Mailing Address - Fax:
Practice Address - Street 1:509 MARKET ST
Practice Address - Street 2:UNIT 1001
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-5097
Practice Address - Country:US
Practice Address - Phone:248-835-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)