NPI 1033392436

Shopko Stores Operating Co LLC

Organisation Community/Retail Pharmacy Green Bay, WI

Practice location

Address: 2320 Lineville Rd, Green Bay, WI 54313-8836
Phone: (920) 434-5846

Authorised official

Name: Michael Bettiga
Title: Sr. Vice President Health Services
Phone: (920) 429-4297

Registered specialties (4)

Community/Retail Pharmacy Primary

Suppliers Taxonomy 3336C0003X Licence 8798042 (WI)

Other Pharmacy providers in Wisconsin →

Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

Other Durable Medical Equipment & Medical Supplies providers in Wisconsin →

Eyewear Supplier

Suppliers Taxonomy 332H00000X

Other Eyewear Supplier providers in Wisconsin →

Pharmacy

Suppliers Taxonomy 333600000X

Registry record

NPI: 1033392436
Entity type: Organization
NPI issued: 10 Dec 2007
Record last updated: 28 Oct 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.