NPI 1114113511
Shopko Stores Operating Co LLC
Practice location
- Address
- 925 N 6th Street, Greybull, WY 82426
- Phone
- (307) 765-4601
- Fax
- (307) 765-4600
- Mailing address
- 925 N 6th St, Greybull, WY 82426
Authorised official
- Name
- Michael Bettiga
- Title
- Executive Vice President & Coo
- Phone
- (920) 429-4297
Registered specialties (3)
Community/Retail Pharmacy
Primary
Durable Medical Equipment & Medical Supplies
Pharmacy
Registry record
- NPI
- 1114113511
- Entity type
- Organization
- NPI issued
- 19 Sep 2007
- Record last updated
- 15 Oct 2012
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.