NPI | 1295786572 |
---|---|
Doing Business As | SHOPKO PHARMACY 083 |
Entity Type | Organization |
Authorized Contact | RUSSELL STEINHORST SVP Chief Financial Officer 920-429-7489 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 1313211703) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
332H00000X Eyewear Supplier (Equipment, not the service) | |
Enumeration Date | 2006-05-12 |
Last Update Date | 2016-08-29 |