# SKY LAKES MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SKY LAKES MEDICAL CENTER INC
- **Other names:** Sky Lakes Specialty Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003654625
- **Legal business name:** SKY LAKES MEDICAL CENTER INC
- **Authorized official:** RICHARD E RICO (VP / CFO)
- **Authorized official phone:** (541) 274-6150

## Contact information

- **Practice address:** 2865 DAGGETT AVE STE B, KLAMATH FALLS, OR 97601-1106
- **Practice address phone:** (541) 274-3760
- **Practice address fax:** (541) 274-3765
- **Mailing address:** 2865 DAGGETT AVE STE B, KLAMATH FALLS, OR 97601-1106
- **Mailing address phone:** (541) 274-3760
- **Mailing address fax:** (541) 274-3765

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/17/2024
- **Last updated:** 07/17/2024