NPI 1780639906

Shopko Stores Operating Co LLC

Organisation Community/Retail Pharmacy Rice Lake, WI

Practice location

Address: 320 S Access Rd, Rice Lake, WI 54868-8572
Phone: (715) 236-7414
Fax: (715) 236-7714

Authorised official

Name: Russell Steinhorst
Title: Svp Chief Financial Officer
Phone: (920) 429-7489

Registered specialties (4)

Community/Retail Pharmacy Primary

Suppliers Taxonomy 3336C0003X Licence 8603042 (WI)

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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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Pharmacy

Suppliers Taxonomy 333600000X

Registry record

NPI: 1780639906
Entity type: Organization
NPI issued: 24 May 2006
Record last updated: 12 Jun 2017

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.