Organization
SKY LAKES MEDICAL CENTER INC
Active
Other names
Sky Lakes Downtown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD RICO (CFO)
(541) 274-6150
Entity
Organization
Contact information
Practice address
211 N 8TH ST, KLAMATH FALLS, OR 97601-6018
(541) 274-3480
(541) 274-3485
Mailing address
211 N 8TH ST., KLAMATH FALLS, OR 97601
(541) 274-3480
(541) 274-3485
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RP-0003343-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176548
PK
—
Enumeration date
11/20/2017
Last updated
07/19/2018
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