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Organization

SKY LAKES OUTPATIENT IMAGING

Active
Parent organization
SKY LAKES MEDICAL CENTER INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SKY LAKES MEDICAL CENTER INC
Authorized official
RICHARD RICO (VP/CFO)
(541) 274-6150
Entity
Organization

Contact information

Practice address
2900 DAGGETT AVE, KLAMATH FALLS, OR 97601-7101
(541) 274-6221
Mailing address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-6221

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
282N00000X
General Acute Care Hospital
14-0724
OR

Other

Enumeration date
03/20/2013
Last updated
08/06/2013
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