NPI 1053621243
Shopko Institutional Care Services Co LLC
Practice location
- Address
- 3701 E Evergreen Dr STE 1000, Appleton, WI 54913-7402
- Phone
- (920) 739-7855
- Fax
- (920) 739-3922
Authorised official
- Name
- Michael Bettiga
- Title
- Executive Vice President and Coo
- Phone
- (920) 429-4297
Registered specialties (2)
Long Term Care Pharmacy
Primary
Durable Medical Equipment & Medical Supplies
Registry record
- NPI
- 1053621243
- Entity type
- Organization
- NPI issued
- 21 Oct 2010
- Record last updated
- 1 Nov 2011
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.