Shopko Stores Operating Co LLC

NPI #1326396516 in Afton, Wyoming

Provider Information

NPI Number
1326396516
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Aug 21, 2012
Last Updated
Aug 21, 2012

Practice Location

Address
439 S WASHINGTON ST
City
Afton
State
Wyoming
ZIP Code
83110-9773
Phone
(307) 885-9804

Authorized Official

Name
MICHAEL BETTIGA, RPH
Title
EXECUTIVE VICE PRESIDENT & 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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