Provider Demographics
NPI:1356597074
Name:SKH MANAGEMENT CO
Entity type:Organization
Organization Name:SKH MANAGEMENT CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT FRESH FOODS COO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-626-4771
Mailing Address - Street 1:301 ROHRERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2232
Mailing Address - Country:US
Mailing Address - Phone:717-397-4710
Mailing Address - Fax:717-735-9680
Practice Address - Street 1:301 ROHRERSTOWN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2232
Practice Address - Country:US
Practice Address - Phone:717-397-4710
Practice Address - Fax:717-735-9680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP4818483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2116756OtherPK
PA102222118001Medicaid
6262630001Medicare NSC