Organization
SHOPKO STORES OPERATING CO LLC
Active
Other names
SHOPKO PHARMACY 796
Organization subpart
No
Provider details
NPI number
Authorized official
LORIE NEUMANN (VP RETAIL HEALTH SERVICES)
(920) 429-4726
Entity
Organization
Contact information
Practice address
301 S MANTORVILLE AVE, KASSON, MN 55944
(507) 634-7798
(507) 634-2103
Mailing address
301 S MANTORVILLE AVE, KASSON, MN 55944
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/16/2014
Last updated
10/28/2014
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