Shopko Pharmacy 688

LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 688 is an health care organization with primary practice located at 413 W Huron St , Missouri Valley IA 51555-1436. 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 (712) 642-2716, or through Bettiga, Michael via phone (920) 429-4297.

Contact Information

Primary practice address
413 W Huron St Missouri Valley IA 51555-1436
Phone: (712) 642-2716
Fax: (712) 642-3961
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 1770535866
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as Shopko Pharmacy 688
Authorized official Bettiga, Michael RPH
Entity Organization
Organization subpart 1 No
Enumeration date May 17th, 2006
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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Identifiers

StateTypeNumberIssuer
All States NPI 1770535866 NPPES
Iowa MEDICAID 0495911
Iowa MEDICAID 0268078
Iowa Other 1621235

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