Shopko Stores Operating Co LLC

NPI #1376579334 in Dixon, Illinois

Provider Information

NPI Number
1376579334
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
1350 N GALENA AVE
City
Dixon
ZIP Code
61021-1010
Phone
(815) 284-4127

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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