Shopko Pharmacy 668

LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 668 is an health care organization with primary practice located at 660 W Milwaukee St , New Hampton IA 50659-1013. 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 (641) 394-6404, or through Bettiga, Michael via phone (920) 429-4297.

Contact Information

Primary practice address
660 W Milwaukee St New Hampton IA 50659-1013
Phone: (641) 394-6404
Fax: (641) 394-2958
Website:
Map and Directions
Authorized official contact:
Name: Bettiga, Michael RPH
Phone: (920) 429-4297

Health care specialties

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

Profile Details

NPI number 1265485858
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as Shopko Pharmacy 668
Authorized official Bettiga, Michael RPH
Entity Organization
Organization subpart 1 No
Enumeration date May 18th, 2006
Last updated Oct 25th, 2012 - about 13 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 1265485858 NPPES
Iowa MEDICAID 0446930
Iowa Other 1622136
Iowa MEDICAID 0495580

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