NPIMap

Organization Active NPI

Sky Lakes Medical Center Inc

Doing business as Sky Lakes Specialty Pharmacy

  • Community/Retail Pharmacy
  • Klamath Falls, OR
National Provider Identifier
1003654625
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SKY LAKES MEDICAL CENTER INC
Doing business as
Sky Lakes Specialty Pharmacy
Practice address
2865 Daggett Ave Ste B
Klamath Falls, OR 97601-1106
Phone
(541) 274-3760
Fax
(541) 274-3765
NPI assigned
Jul 17, 2024
Last updated
Jul 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SKY LAKES MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard E Rico
Title
VP / Cfo
Phone
(541) 274-6150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

2865 Daggett Ave Ste B
Klamath Falls, OR 97601-1106

Mailing address

2865 Daggett Ave Ste B
Klamath Falls, OR 97601-1106
Phone (541) 274-3760

Other names 1

  • Sky Lakes Specialty Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250117002882 OR DME Supplier - Pharmacy 1052204096 Practice locations: Klamath Falls, OR

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Merle West Medical CNTR23 organizations share this tax ID, including this one
Part of
Merle West Medical CNTR

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

1435 Esplanade Ave
Klamath Falls, OR 97601
Phone (541) 883-6220

2200 Bryant Williams Dr
Ste 1
Klamath Falls, OR 97601
Phone (541) 884-3677

2200 Bryant Williams Dr
Ste 7
Klamath Falls, OR 97601
Phone (218) 670-0458

2301 Clairmont Dr
Ste A
Klamath Falls, OR 97601
Phone (541) 274-6556

2303 Clairmont Dr
Klamath Falls, OR 97601
Phone (541) 850-8627

2421 Washburn Way
Ste C
Klamath Falls, OR 97603
Phone (541) 274-3420

2421 Washburn Way
Ste H
Klamath Falls, OR 97603
Phone (541) 274-6289

2801 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 274-4510

2865 Daggett Ave
Ste B
Klamath Falls, OR 97601
Phone (541) 274-3760

2900 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 884-1371

3000 Bryant Williams Dr
Klamath Falls, OR 97601
Phone (541) 274-3000

3000 Bryant Williams Dr
Ste 100
Klamath Falls, OR 97601
Phone (541) 274-2345

3000 Bryant Williams Dr
Ste 110
Klamath Falls, OR 97601
Phone (541) 274-2345

3000 Bryant Williams Dr
Ste 220
Klamath Falls, OR 97601
Phone (541) 850-2032

3001 Daggett Ave
Ste 101
Klamath Falls, OR 97601
Phone (541) 274-3278

Practitioners & affiliated clinicians

Practitioners 341

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 341

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1003654625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE STE B",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-3760",
            "fax_number": "541-274-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE STE B",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-3760",
            "fax_number": "541-274-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKY LAKES MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SKY LAKES MEDICAL CENTER INC",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "RICO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP / CFO",
        "authorized_official_telephone_number": "541-274-6150"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sky Lakes Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.