Shopko Stores Operating Co Llc in Jacksonville - Durable Medical Equipment & Medical Supplies
Shopko Stores Operating Co Llc - NPI 1912933961
Shopko Stores Operating Co Llc is a Durable Medical Equipment & Medical Supplies in Jacksonville, Illinois. Shopko Stores Operating Co Llc practices all healthcare services and medical treatments related to Durable Medical Equipment & Medical Supplies. The NPI Number for Shopko Stores Operating Co Llc is 1912933961. The last update date is 2014-05-22.
Shopko Stores Operating Co Llc's current location address is 1964 W Morton Ave, Jacksonville, Illinois. You can contact this provider via phone number 2172456259 and fax number 2172439251. The mailing address for Shopko Stores Operating Co Llc is 1964 W Morton Ave, Jacksonville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shopko Stores Operating Co Llc |
|---|---|
| Address | 1964 W Morton Ave, Jacksonville, Illinois |
| Phone Number | 2172456259 |
| Fax Number | 2172439251 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | SR. VICE P |
|---|---|
| Authorized Official Name | Bettiga J Michael |
| Credentials | RPH |
| Telephone Number | 9204294297 |
NPI Number Detail
| NPI Number | 1912933961 |
|---|---|
| Provider Enumeration Date | 2006-06-23 |
| Last Updated Date | 2014-05-22 |
Provider Mailing Address Detail
| Address | 1964 W Morton Ave |
|---|---|
| City | Jacksonville |
| State | Illinois (IL) |
| Post Code | 626502621 |
| Phone Number | 2172456259 |
| Fax Number | 2172439251 |
Provider's Primary Taxonomy Detail
| Speciality | Durable Medical Equipment & Medical Supplies |
|---|---|
| Taxonomy | 332B00000X |
|
Definition: A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1468722 | NCPDP NUMBER | ||
| 371110040140 | IL | -- |
Post Comment/ Review Below
What is the Shopko Stores Operating Co Llc's unique identification number?
The Shopko Stores Operating Co Llc has been assigned the NPI (National Provider Identifier) Number 1912933961 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Shopko Stores Operating Co Llc is physically located?
The Shopko Stores Operating Co Llc is physically situated at the following address: 1964 W Morton Ave, Jacksonville, IL, 626502621.
What is Shopko Stores Operating Co Llc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Shopko Stores Operating Co Llc is Durable Medical Equipment & Medical Supplies, and the corresponding taxonomy classification code for this specialized field is 332B00000X.
On what date did the Shopko Stores Operating Co Llc receive its 1912933961 assignment from the Centers for Medicare & Medicaid Services?
The Shopko Stores Operating Co Llc was assigned its 1912933961 by the Centers for Medicare & Medicaid Services on 2006-06-23.
When was the information regarding Shopko Stores Operating Co Llc most recently updated?
The details pertaining to the Shopko Stores Operating Co Llc, including its address, specialty, and other relevant information, were last refreshed on 2014-05-22.