Organization
SKY LAKES MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD E RICO (VP)
(541) 274-6150
Entity
Organization
Contact information
Practice address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-6221
(541) 274-6247
Mailing address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-6221
(541) 274-6247
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
282N00000X
General Acute Care Hospital
Primary
140724
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0033522
—
OR
05
—
011198
—
OR
05
—
01556
—
OR
05
—
017881103
—
OR
05
—
020406500A
—
OR
05
—
0413257
—
OR
05
—
066167
—
OR
05
—
100457850A
—
OR
05
—
152371
—
OR
05
—
7126139
—
OR
05
—
717315600
—
OR
05
—
82508600
—
OR
05
—
HSP60101F
—
OR
05
—
ZZR20101F
—
OR
Enumeration date
03/15/2006
Last updated
12/15/2025
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