<Unavail>

LBN: Shopko Stores Operating Co Llc
<Unavail> is an health care organization with primary practice located at 174 James Robertson Dr , Gladwin MI 48624-7006. 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 (989) 426-7020, or through Steinhorst, Russell via phone (920) 429-7489.

Contact Information

Primary practice address
174 James Robertson Dr Gladwin MI 48624-7006
Phone: (989) 426-7020
Fax: (989) 426-7155
Website:
Map and Directions
Authorized official contact:
Name: Steinhorst, Russell
Phone: (920) 429-7489

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1134172794
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as <Unavail>
Authorized official Steinhorst, Russell
Entity Organization
Organization subpart 1 No
Enumeration date May 17th, 2006
Last updated Dec 14th, 2015 - about 11 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 1134172794 NPPES
Michigan MEDICAID 4913866
Michigan MEDICAID 3247754
Michigan MEDICAID 2355661
Michigan Other 2355661
Michigan MEDICAID 4819283

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