MEDICARE: SKINNER PHARMACIES INC

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0004X	Compounding Pharmacy
4	3336L0003X	Long Term Care Pharmacy
5	3336C0003X	Community/Retail Pharmacy	35-6773	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2146917	OTHER		PK
3	35-8947	OTHER	OK	PHARMACY LICENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235546565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKINNER PHARMACIES INC

Provider Business Mailing Address
First Line	:	809 NORTH MAIN STREET
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-4751
Country	:	US
Telephone Number	:	580-225-3263
Fax Number	:	580-225-4216

Provider Business Practice Location Address
First Line	:	809 NORTH MAIN STREET
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-4751
Country	:	US
Telephone Number	:	580-225-2121
Fax Number	:	580-225-4216

Authorized Official
Title or Position	:	VP
Name	:	WILLIAM EARL OSBORN
Credential	:
Telephone Number	:	918-542-4444

Provider Enumeration Date	:	07/18/2014
Last Update Date	:	05/22/2025

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Directions to “SKINNER PHARMACIES INC ” Practice Location

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