<Unavail>
LBN: Shopko Stores Operating Co. Llc
<Unavail> is an health care organization with primary practice located at 2323 W Pioneer Pkwy , Peoria IL 61615-1833. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Durable Medical Equipment & Medical Supplies is the primary health care specialty.
Shopko Stores Operating Co. Llc can be contacted via phone (309) 691-4682, or through Bettiga, Michael J via phone (920) 429-4297.
Contact Information
Primary practice address
2323 W Pioneer Pkwy
Peoria IL 61615-1833
Phone: (309) 691-4682
Fax: (309) 691-4807
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | Illinois |
Profile Details
| NPI number | 1538195300 |
|---|---|
| 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 | Jun 24th, 2006 |
| Last updated | Sep 11th, 2025 - about last year |
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 | 1538195300 | NPPES |
| Illinois | MEDICAID | 410985054174 | |
| Illinois | Other | 1473014 |
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