NPI | 1235176983 |
---|---|
Doing Business As | SHOPKO PHARMACY 169 |
Entity Type | Organization |
Authorized Contact | MICHAEL J BETTIGA Sr. Vice President Health Services 920-429-4297 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: ID 2038CP) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
333600000X Pharmacy (Licence: ID 2038CP) | |
Enumeration Date | 2006-06-01 |
Last Update Date | 2009-07-10 |