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NPI Code Detail

MEDICARE: SKY NEAK PHARMACY INC.

MEDICARE: SKY NEAK PHARMACY 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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12121504OTHERPK

General Provider Information

NPI Number : 1588893655
Entity Type Code : Organization
Provider Name (Legal Business Name) : SKY NEAK PHARMACY INC.
Provider Business Mailing Address
First Line : 1515 W MERCED AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3403
Country : US
Telephone Number : 626-962-3685
Fax Number : 626-962-3515
Provider Business Practice Location Address
First Line : 1515 W MERCED AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3403
Country : US
Telephone Number : 626-962-3685
Fax Number : 626-962-3515
Authorized Official
Title or Position : CEO
Name : ALLISON LEE SOU
Credential : RPH
Telephone Number : 818-281-7283
Provider Enumeration Date : 07/09/2009
Last Update Date : 07/24/2025

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1619859535 — SKY NEAK PHARMACY INC.
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91790-3403
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Practice Fax: 626-962-3686

Directions to “SKY NEAK PHARMACY INC. ” Practice Location

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