Shopko Stores Operating Co LLC
NPI #1215108758 in Gothenburg, Nebraska
Provider Information
- NPI Number
- 1215108758
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Mar 12, 2008
- Last Updated
- Dec 27, 2012
Practice Location
- Address
- 718 4TH STREET
- City
- Gothenburg
- State
- Nebraska
- ZIP Code
- 69138
- Phone
- (308) 537-8780
Authorized Official
- Name
- MR. MICHAEL BETTIGA, RPH
- Title
- EXECUTIVE VICE PRESIDENT AND COO
- Phone
- (920) 429-4297
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Durable Medical Equipment & Medical Supplies |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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