Provider Demographics
NPI:1568462349
Name:DANNY SKAGGS COMPANY INC
Entity Type:Organization
Organization Name:DANNY SKAGGS COMPANY INC
Other - Org Name:PHARMACY UNLIMITED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:432-580-5123
Mailing Address - Street 1:PO BOX 592602
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0179
Mailing Address - Country:US
Mailing Address - Phone:432-580-5123
Mailing Address - Fax:432-333-1916
Practice Address - Street 1:12801 WETMORE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3628
Practice Address - Country:US
Practice Address - Phone:432-580-5123
Practice Address - Fax:432-333-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX231053336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145453Medicaid
TX163014701Medicaid
2095628OtherPK
TX163014701Medicaid
3828810001Medicare NSC