Shopko Stores Operating Co LLC
NPI #1407127889 in Lake Mills, Wisconsin
Provider Information
- NPI Number
- 1407127889
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jan 18, 2012
- Last Updated
- Apr 20, 2012
Practice Location
- Address
- 203 N MAIN ST
- City
- Lake Mills
- State
- Wisconsin
- ZIP Code
- 53551-1610
- Phone
- (920) 648-3455
Authorized Official
- Name
- MICHAEL BETTIGA, RPH
- Title
- EXECUTIVE VICE PRESIDENT AND COO
- Phone
- (920) 429-4297
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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