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Organization
SKY LAKES MEDICAL CENTER INC
Active
Organization
SKY LAKES MEDICAL CENTER INC
Active
Other names
Sky Lakes Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD RICO (CFO)
(541) 274-6150
Entity
Organization
Contact information
Practice address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-3491
(541) 274-3495
Mailing address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-3491
(541) 274-3495
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP0002929
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146304
PK
—
Enumeration date
06/17/2014
Last updated
06/22/2015
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