NPI | 1659316107 |
---|---|
Doing Business As | SHOPKO PHARMACY 096 |
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: CA PHY47484) |
Enumeration Date | 2006-06-18 |
Last Update Date | 2008-08-14 |