NPI 1073568242
Shopko Stores Operating Co LLC
Practice location
- Address
- 301 Bay Park Sq, Green Bay, WI 54304-5104
- Phone
- (920) 499-5889
- Fax
- (920) 499-9215
Authorised official
- Name
- Michael J Bettiga
- Title
- Sr. Vice President Health Services
- Phone
- (920) 429-4297
Registered specialties (4)
Community/Retail Pharmacy
Primary
Durable Medical Equipment & Medical Supplies
Eyewear Supplier
Pharmacy
Registry record
- NPI
- 1073568242
- Entity type
- Organization
- NPI issued
- 24 May 2006
- Record last updated
- 6 Jun 2014
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.