Shopko Stores Operating Co Llc in Grafton - Community/retail Pharmacy
Shopko Stores Operating Co Llc - NPI 1740236199
Shopko Stores Operating Co Llc is a Community/retail Pharmacy in Grafton, Wisconsin. Shopko Stores Operating Co Llc practices all healthcare services and medical treatments related to Community/retail Pharmacy. The NPI Number for Shopko Stores Operating Co Llc is 1740236199. The last update date is 2014-06-06.
Shopko Stores Operating Co Llc's current location address is 1771 Wisconsin Ave, Grafton, Wisconsin. You can contact this provider via phone number 2623750016 and fax number 2623753519. The mailing address for Shopko Stores Operating Co Llc is 1771 Wisconsin Ave, Grafton, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shopko Stores Operating Co Llc |
|---|---|
| Address | 1771 Wisconsin Ave, Grafton, Wisconsin |
| Phone Number | 2623750016 |
| Fax Number | 2623753519 |
| 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 | 1740236199 |
|---|---|
| Provider Enumeration Date | 2006-05-26 |
| Last Updated Date | 2014-06-06 |
Provider Mailing Address Detail
| Address | 1771 Wisconsin Ave |
|---|---|
| City | Grafton |
| State | Wisconsin (WI) |
| Post Code | 530242437 |
| Phone Number | 2623750016 |
| Fax Number | 2623753519 |
Provider's Primary Taxonomy Detail
| Speciality | Community/retail Pharmacy |
|---|---|
| Taxonomy | 3336C0003X |
| Licence No | 8605042 |
|
Definition: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing pr |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 33162200 | WI | -- | |
| 5119450 | NCPDP NUMBER |
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What is the unique 10-digit identifier code issued to Shopko Stores Operating Co Llc by the Centers for Medicare & Medicaid Services?
The Shopko Stores Operating Co Llc has been assigned the NPI (National Provider Identifier) 1740236199 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Shopko Stores Operating Co Llc is located?
The Shopko Stores Operating Co Llc is situated at the following address: 1771 Wisconsin Ave, Grafton, WI, 530242437.
What is the Shopko Stores Operating Co Llc's specialty and taxonomy code?
The Shopko Stores Operating Co Llc's specialty is Community/retail Pharmacy, and the corresponding taxonomy code is 3336C0003X.
When did Shopko Stores Operating Co Llc receive its 1740236199 assignment?
The Shopko Stores Operating Co Llc was assigned its 1740236199 on 2006-05-26, which is the date when this unique identifier was issued to the organization.
When was the information related to Shopko Stores Operating Co Llc most recently updated or refreshed?
The details pertaining to the Shopko Stores Operating Co Llc, including its address, specialty, and other relevant information, were last updated or refreshed on 2014-06-06.
NPI Number: 1376546309
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