Shopko Stores Operating Co LLC

NPI #1235176983 in Meridian, Idaho

Provider Information

NPI Number
1235176983
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jun 1, 2006
Last Updated
Jul 10, 2009

Practice Location

Address
3499 E FAIRVIEW AVE
State
Idaho
ZIP Code
83642-5848
Phone
(208) 884-1286

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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