Provider Demographics
NPI:1992085450
Name:SKULA, COREY (PHARM D)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:SKULA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WILKES BARRE TOWNSHIP BLVD
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6604
Mailing Address - Country:US
Mailing Address - Phone:570-235-2001
Mailing Address - Fax:570-235-2007
Practice Address - Street 1:400 WILKES BARRE TOWNSHIP BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6604
Practice Address - Country:US
Practice Address - Phone:570-235-2001
Practice Address - Fax:570-235-2007
Is Sole Proprietor?:No
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442625183500000X
AZ13734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist