Shopko Stores Operating Co LLC
NPI #1912933961 in Jacksonville, Illinois
Provider Information
- NPI Number
- 1912933961
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jun 23, 2006
- Last Updated
- May 22, 2014
Practice Location
- Address
- 1964 W MORTON AVE
- City
- Jacksonville
- State
- Illinois
- ZIP Code
- 62650-2621
- Phone
- (217) 245-6259
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 Pharmacy — Community/Retail Pharmacy |
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