Provider Demographics
NPI:1184946196
Name:S&K HEALTHCARE LLC
Entity type:Organization
Organization Name:S&K HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SACHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-338-1111
Mailing Address - Street 1:1880 BRASELTON HWY STE 121
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-2877
Mailing Address - Country:US
Mailing Address - Phone:770-338-1111
Mailing Address - Fax:770-338-1120
Practice Address - Street 1:1880 BRASELTON HWY STE 121
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-2877
Practice Address - Country:US
Practice Address - Phone:770-338-1111
Practice Address - Fax:770-338-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
GAPHRE0096393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2124125OtherPK