Shopko Stores Operating Co LLC
NPI #1619922028 in Port Washington, Wisconsin
Provider Information
- NPI Number
- 1619922028
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- May 24, 2006
- Last Updated
- Aug 15, 2008
Practice Location
- Address
- 1011 N WISCONSIN ST
- City
- Port Washington
- State
- Wisconsin
- ZIP Code
- 53074-1207
- Phone
- (262) 284-3436
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 |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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