Shopko Stores Operating Co LLC

NPI #1164841110 in Mayville, Wisconsin

Provider Information

NPI Number
1164841110
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Apr 7, 2014
Last Updated
Apr 7, 2014

Practice Location

Address
2050 HORICON ST
ZIP Code
53050
Phone
(920) 387-0257

Authorized Official

Name
MICHAEL BETTIGA, RPH
Title
EVP & COO
Phone
(920) 429-4297

Specialties & Taxonomy Codes

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

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