Organization
SHOPKO STORES OPERATING CO LLC
Active
Organization
SHOPKO STORES OPERATING CO LLC
Active
Other names
Shopko Pharmacy 2624
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL STEINHORST (EVP AND COO)
(920) 429-7489
Entity
Organization
Contact information
Practice address
15900 PICTURE BAY TRAIL, L'ANSE, MI 49946-8125
(906) 524-7032
Mailing address
15900 PICTURE BAY TRAIL, L'ANSE, MI 49946-8125
(906) 524-7032
(906) 524-7020
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
07/17/2008
Last updated
12/15/2015
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