NPI 1104875731

Shopko Stores Operating Co LLC

Organisation Community/Retail Pharmacy Marquette, MI

Practice location

Address: 1150 W Washington St, Marquette, MI 49855-4040
Phone: (906) 228-8380
Fax: (906) 228-3565

Authorised official

Name: Russell Steinhorst
Title: Svp and Cfo
Phone: (920) 429-7489

Registered specialties (3)

Community/Retail Pharmacy Primary

Suppliers Taxonomy 3336C0003X Licence 5301008354 (MI)

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Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

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Eyewear Supplier

Suppliers Taxonomy 332H00000X

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Registry record

NPI: 1104875731
Entity type: Organization
NPI issued: 10 May 2006
Record last updated: 15 Dec 2015

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.