Shopko Stores Operating Co Llc
Shopko Stores Operating Co Llc is a health care provider in Kiel, WI. In this page you will find its mailing address, practice location, phone number, specialty etc.
|Practice Location|| 1120 State Road 67, Kiel, WI 53042-1630, US |
|Practice Location Phone||920-429-4243|
|Practice Location Fax|
|Legal Business Name||SHOPKO STORES OPERATING CO LLC|
|Other Organization Name||SHOPKO PHARMACY 609|
|Other Organization Name Type||Doing Business As Name|
|Enumeration Date ? ||Aug 3, 2011|
|Last Update Date ? ||Feb 2, 2012|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
Specialties & Licenses of Shopko Stores Operating Co Llc
|Specialty||Provider Type||Specialization||License||License State|
|Durable Medical Equipment & Medical Supplies||Suppliers|| |
|Eyewear Supplier (Equipment, not the service)||Suppliers|| |
|Pharmacy||Suppliers||Community/Retail Pharmacy |
Legacy Provider IDs of Shopko Stores Operating Co Llc
|Provider Id||Issuer State||Issuer Type||Issuer|
Authorized Official of Shopko Stores Operating Co Llc
An authorized official is an appointed official with the legal authority to make changes and/or updates to the Shopko Stores Operating Co Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).
|Authorized Official ||Mr. Michael Bettiga (RPH)|
|Authorized Official Title/Position||EXECUTIVE VICE PRESIDENT & COO|
|Authorized Official Phone Number||920-429-4297|