Organization
SKYCOM BROADBAND LLC
Active
Parent organization
SKYCOM BROAD, LLC
Other names
MedLyft, LLC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SKYCOM BROAD, LLC
Authorized official
MS. IRENE MARTINEZ BOUCHEREAU (PRESIDENT CEO)
(540) 895-7466
Entity
Organization
Contact information
Practice address
11016 FOREST HOLLOW DR, BUMPASS, VA 23024-9698
(540) 242-8486
(540) 895-7466
Mailing address
11016 FOREST HOLLOW DR, BUMPASS, VA 23024-9698
(540) 242-8486
(540) 895-7466
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
344600000X
Taxi
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
10/02/2019
Last updated
10/12/2019
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