Provider Demographics
NPI:1316774557
Name:SKY LANSING
Entity type:Organization
Organization Name:SKY LANSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MD NIZAMUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ISLAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-237-9415
Mailing Address - Street 1:37663 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-3929
Mailing Address - Country:US
Mailing Address - Phone:586-237-9415
Mailing Address - Fax:
Practice Address - Street 1:37663 EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-3929
Practice Address - Country:US
Practice Address - Phone:586-237-9415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)