Shopko Stores Operating Co Llc in Green Bay - Community/retail Pharmacy

Shopko Stores Operating Co Llc - NPI 1356505408

Shopko Stores Operating Co Llc is a Community/retail Pharmacy in Green Bay, 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 1356505408. The last update date is 2009-01-05.

Shopko Stores Operating Co Llc's current location address is 300 N Broadway, Green Bay, Wisconsin. You can contact this provider via phone number 9204301505 and fax number 9204301773. The mailing address for Shopko Stores Operating Co Llc is 300 N Broadway, Green Bay, Wisconsin. To know further, please read the information below!

Provider Profile Detail

Provider Organization Shopko Stores Operating Co Llc
Address 300 N Broadway, Green Bay, Wisconsin
Phone Number 9204301505
Fax Number 9204301773
Sole Proprietor --
Credentials --

Authorized Official

Title or Position SR. VICE P
Authorized Official Name Bettiga Michael
Credentials RPH
Telephone Number 9204294297

NPI Number Detail

NPI Number 1356505408
Provider Enumeration Date 2008-07-17
Last Updated Date 2009-01-05

Provider Mailing Address Detail

Address 300 N Broadway
City Green Bay
State Wisconsin (WI)
Post Code 543032753
Phone Number 9204301505
Fax Number 9204301773

Provider's Primary Taxonomy Detail

Speciality Community/retail Pharmacy
Taxonomy 3336C0003X
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

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
5131026 NCPDP
36230700 WI --

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FAQs about Shopko Stores Operating Co Llc

What is the Shopko Stores Operating Co Llc's 1356505408?

The Shopko Stores Operating Co Llc's NPI (National Provider Identifier) Number is 1356505408. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).

Could you provide the complete address where Shopko Stores Operating Co Llc is physically located?

The Shopko Stores Operating Co Llc is situated at the following address: 300 N Broadway, Green Bay, WI 543032753.

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.

On what date did Shopko Stores Operating Co Llc receive its 1356505408 assignment from the Centers for Medicare & Medicaid Services?

The Shopko Stores Operating Co Llc was assigned its 1356505408 on 2008-07-17, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.

As of what date was the information pertaining to Shopko Stores Operating Co Llc, such as address, specialty, and other details, last reviewed and confirmed to be accurate?

The information related to Shopko Stores Operating Co Llc, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2009-01-05.

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