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General NPI Number Information
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NPI Number | 1376926592
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Entity Type | Organization
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Legal Business Name | OSKY PHARMACY LLC
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 504 A AVE W
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City | OSKALOOSA
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State | IA
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Zip | 52577-2708
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Country | US
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Telephone | 641-673-8486
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Fax | 641-673-8698
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Provider Business Mailing Address
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Address Line | 504 A AVE W
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City | OSKALOOSA
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State | IA
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Zip | 52577-2708
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Country | US
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Telephone | 641-673-8486
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Fax | 641-673-8698
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Authorized Official
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Title or Position | PIC
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Name | RAJAN DEVAN
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Credential |
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Telephone | 641-673-8486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1538
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License Number State | IA
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