Shopko Stores Operating Co LLC

NPI #1962750158 in Thayne, Wyoming

Provider Information

NPI Number
1962750158
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Aug 21, 2012
Last Updated
Aug 21, 2012

Practice Location

Address
190 NORTH MAIN
City
Thayne
State
Wyoming
ZIP Code
83127-1607
Phone
(307) 883-4600

Authorized Official

Name
MICHAEL BETTIGA, RPH
Title
EXECUTIVE VICE PRESIDENT & 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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