NPI 1174576763

Shopko Stores Operating Co LLC

Organisation Community/Retail Pharmacy Broken Bow, NE

Practice location

Address: 2353 South E, Broken Bow, NE 68822-2031
Phone: (308) 872-6818
Fax: (308) 872-6889
Mailing address: PO Box 383, Broken Bow, NE 68822-0383

Authorised official

Name: Michael Bettiga
Title: Executive Vice President & Coo
Phone: (920) 429-4297

Registered specialties (3)

Community/Retail Pharmacy Primary

Suppliers Taxonomy 3336C0003X

Other Pharmacy providers in Nebraska →

Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

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Pharmacy

Suppliers Taxonomy 333600000X

Registry record

NPI: 1174576763
Entity type: Organization
NPI issued: 18 May 2006
Record last updated: 23 Jan 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.