| NPI | 1134172794 |
|---|---|
| Doing Business As | SHOPKO PHARMACY 2653 |
| Entity Type | Organization |
| Authorized Contact | RUSSELL STEINHORST SVP And COO 920-429-7489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2015-12-14 |