Provider Demographics
NPI:1477541845
Name:SKYLINE RX INC
Entity type:Organization
Organization Name:SKYLINE RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:SENG
Authorized Official - Middle Name:K
Authorized Official - Last Name:TAING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-870-0577
Mailing Address - Street 1:7320 WOODLAKE AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1468
Mailing Address - Country:US
Mailing Address - Phone:844-870-0577
Mailing Address - Fax:844-870-0578
Practice Address - Street 1:7320 WOODLAKE AVE
Practice Address - Street 2:STE 100
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1468
Practice Address - Country:US
Practice Address - Phone:844-870-0577
Practice Address - Fax:844-870-0578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA501493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY 50149OtherBOARD OF PHARMACY PERMIT
0545852OtherNCPDP PROVIDER IDENTIFICATION NUMBER