Shopko Pharmacy 754

LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 754 is an health care organization with primary practice located at 2100 E Cedar St , Rawlins WY 82301-6029. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Shopko Stores Operating Co Llc can be contacted via phone (307) 324-5276, or through Bettiga, Michael via phone (920) 429-4297.

Contact Information

Primary practice address
2100 E Cedar St Rawlins WY 82301-6029
Fax: (307) 324-5277
Website:
Authorized official contact:
Name: Bettiga, Michael RPH

Health care specialties

Profile Details

NPI number 1033158944
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as Shopko Pharmacy 754
Authorized official Bettiga, Michael RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jun 6th, 2006
Last updated Dec 27th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033158944 NPPES
Wyoming MEDICAID 123291601
Wyoming MEDICAID 113814600
Wyoming MEDICAID 123291600
Wyoming Other 5203372

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