Provider Demographics
NPI:1316700941
Name:SKP LLC
Entity type:Organization
Organization Name:SKP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAPAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:631-672-0456
Mailing Address - Street 1:5004 GULFPORT BLVD S
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33707-4942
Mailing Address - Country:US
Mailing Address - Phone:727-223-1075
Mailing Address - Fax:727-388-8217
Practice Address - Street 1:5004 GULFPORT BLVD S
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:FL
Practice Address - Zip Code:33707-4942
Practice Address - Country:US
Practice Address - Phone:727-223-1075
Practice Address - Fax:727-388-8217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy