Organization
SKY PROSTHETICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN WAYNE BLECHA C.P.O. (OWNER PRESIDENT)
(308) 423-2690
Entity
Organization
Contact information
Practice address
503 CHIEF ST, BENKELMAN, NE 69021-3065
(308) 423-2690
(308) 423-2691
Mailing address
503 CHIEF ST, BENKELMAN, NE 69021-3065
(308) 423-2690
(308) 423-2691
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO 2571
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000118447
BLUE CROSS BLUE SHIELD
KS
01
—
09904
BLUE CROSS BLUE SHIELD
NE
05
—
100025425600
—
NE
05
—
1659570
—
CO
Enumeration date
04/25/2007
Last updated
11/30/2007
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