Shopko Pharmacy 790

LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 790 is an health care organization with primary practice located at 409 Junction Ave , Stanley WI 54768-8011. 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 (715) 644-6168, or through Bettiga, Michael via phone (920) 429-4297.

Contact Information

Primary practice address
409 Junction Ave Stanley WI 54768-8011
Phone: (715) 644-6168
Fax: (715) 644-5956
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 1578811675
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as Shopko Pharmacy 790
Authorized official Bettiga, Michael RPH
Entity Organization
Organization subpart 1 No
Enumeration date Aug 21st, 2012
Last updated Jan 25th, 2013 - 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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