NPI | 1811943269 |
---|---|
Doing Business As | SHOPKO PHARMACY 015 |
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: WI 8592042) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
333600000X Pharmacy | |
332H00000X Eyewear Supplier (Equipment, not the service) | |
Enumeration Date | 2006-05-26 |
Last Update Date | 2014-01-21 |