Organization
SHOPKO STORES OPERATING CO LLC
Active
Other names
ShopKo Pharmacy 100
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J BETTIGA RPH (SR. VICE PRESIDENT HEALTH SERVICES)
(920) 429-4297
Entity
Organization
Contact information
Practice address
699 GREEN BAY RD, NEENAH, WI 54956-3153
(920) 751-0270
(920) 751-0267
Mailing address
699 GREEN BAY RD, NEENAH, WI 54956-3153
(920) 751-0270
(920) 751-0267
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332H00000X
Eyewear Supplier
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
8599042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33170900
—
WI
01
—
5120136
NCPDP
—
Enumeration date
05/26/2006
Last updated
06/06/2014
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