Shopko Stores Operating Co LLC

NPI #1124074570 in Fort Atkinson, Wisconsin

Provider Information

NPI Number
1124074570
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
May 26, 2006
Last Updated
Aug 7, 2008

Practice Location

Address
1425 JANESVILLE AVE
ZIP Code
53538-2705
Phone
(920) 563-9351

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
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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