MEDICARE: SKYEMED, 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	3336S0011X	Specialty Pharmacy	PH17169	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1089211	OTHER	FL	NCPDP
2	PH17169	OTHER	FL	PHARMACY LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285018234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKYEMED, INC

Provider Business Mailing Address
First Line	:	1332 N FEDERAL HWY
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-3730
Country	:	US
Telephone Number	:	866-778-8255
Fax Number	:	800-432-6614

Provider Business Practice Location Address
First Line	:	1332 N FEDERAL HWY
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-3730
Country	:	US
Telephone Number	:	866-778-8255
Fax Number	:	800-432-6614

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DEEPAK RANADE
Credential	:	RPH
Telephone Number	:	866-778-8255

Provider Enumeration Date	:	07/18/2015
Last Update Date	:	07/18/2015

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Directions to “SKYEMED, INC ” Practice Location

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