Shopko Stores Operating Co LLC
NPI #1780885228 in Green River, Wyoming
Provider Information
- NPI Number
- 1780885228
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- May 31, 2007
- Last Updated
- Jan 25, 2013
Practice Location
- Address
- 1105 BRIDGER DR
- City
- Green River
- State
- Wyoming
- ZIP Code
- 82935-5895
- Phone
- (307) 875-4904
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 Pharmacy — Community/Retail Pharmacy |
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