| NPI | 1639121155 |
|---|---|
| Doing Business As | SHOPKO PHARMACY 111 |
| 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: OR 1193) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2016-04-06 |