Shopko Stores Operating Co LLC
NPI #1124070107 in Georgetown, Ohio
Provider Information
- NPI Number
- 1124070107
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- May 17, 2006
- Last Updated
- Mar 5, 2013
Practice Location
- Address
- 4869 STATE ROUTE 125
- City
- Georgetown
- State
- Ohio
- ZIP Code
- 45121-9550
- Phone
- (937) 378-6849
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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