# SKY LAKES PHYSICIAN SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SKY LAKES MEDICAL CENTER, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1831516772
- **Legal business name:** SKY LAKES MEDICAL CENTER, INC.
- **Authorized official:** RICHARD RICO (VP/CFO)
- **Authorized official phone:** (541) 274-6150

## Contact information

- **Practice address:** 2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
- **Practice address phone:** (541) 274-6221
- **Practice address fax:** (541) 274-6247
- **Mailing address:** 2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
- **Mailing address phone:** (541) 274-6221
- **Mailing address fax:** (541) 274-6247

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 146N00000X | Basic Emergency Medical Technician | — | NULL | Yes |
| 146N00000X | Basic Emergency Medical Technician | — | — | Yes |

## Other

- **Enumeration date:** 03/27/2014
- **Last updated:** 04/25/2015