Organization
SHOPKO STORES OPERATING CO LLC
Active
Other names
Shopko Pharmacy 2528
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORIE NEUMANN (DIR 3D PARTY CONTRACT & CA, HEALTH)
(920) 429-4726
Entity
Organization
Contact information
Practice address
148 MAIN ST, ROUNDUP, MT 59072-2830
(406) 323-1811
(406) 323-1621
Mailing address
148 MAIN ST, ROUNDUP, MT 59072-2830
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
01
—
2783226
NCPDP
—
Enumeration date
09/19/2007
Last updated
07/18/2015
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