# SKICO INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Miller's Pharmacy Long-Term Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437998028
- **Authorized official:** BRADLEY RYAN CRAWFORD PHARMD (PHARMACY MANAGER)
- **Authorized official phone:** (260) 463-7464

## Contact information

- **Practice address:** 420 S DETROIT ST, LAGRANGE, IN 46761-2310
- **Practice address phone:** (260) 463-7464
- **Practice address fax:** (260) 463-8150
- **Mailing address:** 420 S DETROIT ST, LAGRANGE, IN 46761-2310
- **Mailing address phone:** (260) 463-7464
- **Mailing address fax:** (260) 463-8150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/22/2024
- **Last updated:** 05/22/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200259580A | — | IN |