Shopko Stores Operating Co LLC

NPI #1295761252 in Quincy, Illinois

Provider Information

NPI Number
1295761252
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jun 23, 2006
Last Updated
Aug 14, 2008

Practice Location

Address
3200 BROADWAY ST
City
Quincy
ZIP Code
62301-3712
Phone
(217) 224-0776

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 - Community/Retail PharmacyCommunity/Retail Pharmacy

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