Shopko Stores Operating Co LLC

NPI #1760418701 in Freeport, Illinois

Provider Information

NPI Number
1760418701
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jun 23, 2006
Last Updated
Apr 1, 2014

Practice Location

Address
555 W SOUTH ST
ZIP Code
61032-6792
Phone
(815) 232-2724

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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