Individual provider Active NPI

Rainy W Skulkan, RPH

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1770795965
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10357 Issued in AZ
Practice address
3616 E Ray Rd
Phoenix, AZ 85044-7114
Phone
(480) 706-0609
Fax
(480) 706-6078
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10357 AZ Primary

Addresses

Primary practice location

3616 E Ray Rd
Phoenix, AZ 85044-7114

Mailing address

701 W Mountain Sky Ave
Phoenix, AZ 85045-0305
Phone (480) 460-9281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
10357AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiths Food & Drug Centers Inc Past Accepting new patients
Smith's Food & Drug Centers Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770795965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W MOUNTAIN SKY AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850450305",
            "telephone_number": "480-460-9281",
            "fax_number": "480-706-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3616 E RAY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447114",
            "telephone_number": "480-706-0609",
            "fax_number": "480-706-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKULKAN",
        "first_name": "RAINY",
        "middle_name": "W",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "10357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.