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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