MEDICARE: SKELTON DRUG 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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1710030978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKELTON DRUG INC

Provider Business Mailing Address
First Line	:	6344 MAIN ST
Second Line	:	P.O. BOX 386
City	:	NORTH BRANCH
State	:	MN
Zip	:	55056-6693
Country	:	US
Telephone Number	:	651-674-4454
Fax Number	:	651-674-2082

Provider Business Practice Location Address
First Line	:	6344 MAIN ST
Second Line	:
City	:	NORTH BRANCH
State	:	MN
Zip	:	55056-6693
Country	:	US
Telephone Number	:	651-674-4454
Fax Number	:	651-674-2082

Authorized Official
Title or Position	:	PHARMACIST OWNER
Name	:	MR. JOEL LEON SKELTON
Credential	:	RPH
Telephone Number	:	651-674-4454

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	08/22/2020

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Directions to “SKELTON DRUG INC ” Practice Location

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