<Unavail>

LBN: Shopko Stores Operating Co Llc
<Unavail> is an health care organization with primary practice located at 699 Green Bay Rd , Neenah WI 54956-3153. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Eyewear Supplier (Equipment, not the service), 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 (920) 751-0270, or through Bettiga, Michael J via phone (920) 429-4297.

Contact Information

Primary practice address
699 Green Bay Rd Neenah WI 54956-3153
Phone: (920) 751-0270
Fax: (920) 751-0267
Website:
Map and Directions
Authorized official contact:
Name: Bettiga, Michael J RPH
Phone: (920) 429-4297

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 8599042 Wisconsin

Profile Details

NPI number 1386690733
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as <Unavail>
Authorized official Bettiga, Michael J RPH
Entity Organization
Organization subpart 1 No
Enumeration date May 26th, 2006
Last updated Jun 6th, 2014 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1386690733 NPPES
Other 5120136 NCPDP
MEDICAID 33170900 NCPDP

Popular Providers