Skico Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

60005484A Issued in IN

Legal business name

SKICO INC

Practice address

420 S Detroit St
Lagrange, IN 46761-2310

Phone

(260) 463-7464

Fax

(260) 463-8150

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Bradley Ryan Crawford, PHARMDNPI 1164892931

Title

Pharmacy Manager

Phone

(260) 463-7464

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MILLERS PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in IN2 enrollments

Enrollment records 2

Tax ID family

Skico Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Skico Inc

  • Long Term Care Pharmacy
  • Lagrange, IN
  • NPI 1437998028
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley Crawford, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Lagrange, IN
  • NPI 1164892931
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1972672822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S DETROIT ST",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467612310",
            "telephone_number": "260-463-7464",
            "fax_number": "260-463-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S DETROIT ST",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467612310",
            "telephone_number": "260-463-7464",
            "fax_number": "260-463-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKICO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "260-463-7464",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60005484A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200259580A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2024261",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MILLERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rhonda L Sharp, MD
• Leonard Shetler
• Stefanie Irene Shire, APN
• Chrystal Gail Shutt, NUTRITIONIST
• Skico Inc
• Tiffany Nicole Smith, NP
• Ariel Spencer, M.D.
• Angie Stinson, FNP-C
• Annastasia Stover
• Dee L Strycker, LMHC

• Community/Retail Pharmacy in Lagrange, IN
• Providers in Lagrange, IN by specialty
• Community/Retail Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.