Organization Name: | SHOPKO STORES OPERATING CO LLC |
NPI Number: | 1003862442 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL J BETTIGA (SR. VICE PRESIDENT HEALTH SERVICES) |
Mailing Address: | 2430 E Mason St Green Bay |
State: | WI US |
Postal Code: | 543023759 |
Phone Number: | 9204686044 |
Fax Number: | 9204683490 |
NPI Enumeration Date: | 05/26/2006 |
NPI Last Update Date: | 02/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |