Shopko Stores Operating Co LLC

NPI #1073568234 in Boise, Idaho

Provider Information

NPI Number
1073568234
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
May 24, 2006
Last Updated
Mar 21, 2014

Practice Location

Address
8105 FAIRVIEW AVE
City
Boise
State
Idaho
ZIP Code
83704-8486
Phone
(208) 323-9297

Authorized Official

Name
MR. MICHAEL J BETTIGA, RPH
Title
SR. VICE PRESIDENT HEALTH SERVICES
Phone
(920) 429-4297

Specialties & Taxonomy Codes

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

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