Shopko Stores Operating Co LLC
NPI #1104870880 in Park Falls, Wisconsin
Provider Information
- NPI Number
- 1104870880
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- May 19, 2006
- Last Updated
- Aug 24, 2012
Practice Location
- Address
- 1333 4TH AVE S
- City
- Park Falls
- State
- Wisconsin
- ZIP Code
- 54552-1926
- Phone
- (715) 762-4764
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 Pharmacy — Community/Retail Pharmacy |
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