Organization
SKYLAND MRI LLC
Active
Other names
Skyland MRI
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY PETTIJOHN (TREASURER)
(828) 684-2420
Entity
Organization
Contact information
Practice address
1998 HENDERSON HIGHWAY, ASHEVILLE, NC 28803
(828) 687-8141
(828) 687-8142
Mailing address
PO BOX 580, FLETCHER, NC 28732-0580
(828) 684-2420
(828) 687-0729
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015P4
BCBS
NC
05
—
89015P4
—
NC
01
—
P00215051
RR MEDICARE
NC
Enumeration date
01/30/2007
Last updated
10/08/2007
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