NPI 1215988183

Shopko Stores Operating Co LLC

Organisation Community/Retail Pharmacy Burlington, IA

Practice location

Address: 313 N Roosevelt Ave, Burlington, IA 52601-1757
Phone: (319) 758-9526
Fax: (319) 753-2349

Authorised official

Name: Michael J Bettiga
Title: Sr. Vice President Health Services
Phone: (920) 429-4297

Registered specialties (3)

Community/Retail Pharmacy Primary

Suppliers Taxonomy 3336C0003X Licence 1039 (IA)

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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: 1215988183
Entity type: Organization
NPI issued: 15 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.