Shopko Stores Operating Co LLC

NPI #1013946250 in Syracuse, Indiana

Provider Information

NPI Number
1013946250
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 1, 2006
Last Updated
Oct 15, 2012

Practice Location

Address
1101 N INDIANA AVE
State
Indiana
ZIP Code
46567-1019
Phone
(574) 457-3109

Authorized Official

Name
MR. MICHAEL BETTIGA, RPH
Title
EXECUTIVE VICE PRESIDENT & COO
Phone
(920) 429-4297

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies
Pharmacy
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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