Shopko Stores Operating Co LLC

NPI #1083819239 in Gallatin, Missouri

Provider Information

NPI Number
1083819239
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jun 18, 2007
Last Updated
Aug 28, 2012

Practice Location

Address
212 N MAIN ST
ZIP Code
64640-1150
Phone
(111) 111-1111

Authorized Official

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

Specialties & Taxonomy Codes

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

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