Organization
SHOPKO STORES OPERATING CO LLC
Active
Other names
Shopko Pharmacy 773
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BETTIGA RPH (EXECUTIVE VICE PRESIDENT & COO)
(920) 429-4297
Entity
Organization
Contact information
Practice address
825 NE MAIN ST, LEWISTOWN, MT 59457-2080
(406) 538-9262
(406) 538-9795
Mailing address
825 NE MAIN ST, LEWISTOWN, MT 59457-2080
(406) 538-9262
(406) 538-9795
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093769861
—
MT
01
—
2763426
NCPDP
—
Enumeration date
05/19/2006
Last updated
11/20/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us