<Unavail>
LBN: Shopko Institutional Care Services Co Llc
<Unavail> is an health care organization with primary practice located at 3701 E Evergreen Dr Ste 1000, Appleton WI 54913-7402. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty.
Shopko Institutional Care Services Co Llc can be contacted via phone (920) 739-7855, or through Bettiga, Michael via phone (920) 429-4297.
Contact Information
Primary practice address
3701 E Evergreen Dr Ste 1000
Appleton WI 54913-7402
Phone: (920) 739-7855
Fax: (920) 739-3922
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Long Term Care Pharmacy | 3336L0003X | 9041042 | Wisconsin |
Profile Details
| NPI number | 1053621243 |
|---|---|
| LBN Legal business name | Shopko Institutional Care Services Co Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Bettiga, Michael RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 21st, 2010 |
| Last updated | Nov 1st, 2011 - about 15 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053621243 | NPPES |
| Michigan | MEDICAID | 1053621243 | |
| Michigan | MEDICAID | 1053621243 |
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