Shopko Stores Operating Co LLC

NPI #1588845929 in Lyons, Kansas

Provider Information

NPI Number
1588845929
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Nov 14, 2007
Last Updated
Jan 29, 2013

Practice Location

Address
1212 W MAIN
City
Lyons
State
Kansas
ZIP Code
67554
Phone
(620) 257-2821

Authorized Official

Name
MR. 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 PharmacyCommunity/Retail Pharmacy

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