Organization
SKYLINE MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE H CRUM JR. (PRESIDENT)
(413) 731-9988
Entity
Organization
Contact information
Practice address
754 SUMNER AVE, SPRINGFIELD, MA 01108-2218
(413) 731-9988
Mailing address
PO BOX 80384, SPRINGFIELD, MA 01138-0384
(413) 731-9988
(413) 731-5381
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1537806
—
MA
01
—
379654
BCBS MA
—
Enumeration date
10/16/2006
Last updated
08/22/2020
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