MEDICARE: DR. ANTHONY JAMES SKELLY SR. PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH26293	CA

General Provider Information

NPI Number	:	1457483745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY JAMES SKELLY SR. PHARMD

Provider Business Mailing Address
First Line	:	19320 TOMLEE AVE
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-1144
Country	:	US
Telephone Number	:	310-377-4871
Fax Number	:	310-377-8261

Provider Business Practice Location Address
First Line	:	927 DEEP VALLEY DR
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3808
Country	:	US
Telephone Number	:	310-377-4871
Fax Number	:	310-377-8261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/08/2007

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