Shopko Stores Operating Co LLC

NPI #1174579528 in Racine, Wisconsin

Provider Information

NPI Number
1174579528
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
May 26, 2006
Last Updated
Aug 27, 2013

Practice Location

Address
4801 WASHINGTON AVE
City
Racine
ZIP Code
53406-4219
Phone
(262) 637-8444

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
Eyewear Supplier
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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