| NPI | 1003654625 |
|---|---|
| Doing Business As | SKY LAKES SPECIALTY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RICHARD E RICO VP / CFO 541-274-6150 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2024-07-17 |