Shopko Institutional Care Services Co LLC

NPI #1053621243 in Appleton, Wisconsin

Provider Information

NPI Number
1053621243
Entity Type
Organization
Organization Name
Shopko Institutional Care Services Co LLC
Primary Specialty
Pharmacy - Long Term Care Pharmacy
Enumeration Date
Oct 21, 2010
Last Updated
Nov 1, 2011

Practice Location

Address
3701 E EVERGREEN DR
Address 2
STE 1000
ZIP Code
54913-7402
Phone
(920) 739-7855

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies
Pharmacy - Long Term Care PharmacyLong Term Care Pharmacy

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