Shopko Stores Operating Co LLC

NPI #1437100518 in Provo, Utah

Provider Information

NPI Number
1437100518
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
May 13, 2006
Last Updated
May 22, 2014

Practice Location

Address
2266 N UNIVERSITY PKWY
City
Provo
State
Utah
ZIP Code
84604-1510
Phone
(801) 375-2000

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
Eyewear Supplier
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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