Organization
SHOPKO STORES OPERATING CO LLC
Active
Parent organization
SHOPKO PHARMACY 706
Other names
Shopko Pharmacy 706
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHOPKO PHARMACY 706
Authorized official
MICHAEL BETTIGA RPH (EXCUTIVE VICE PRESIDENT & COO)
(920) 429-4297
Entity
Organization
Contact information
Practice address
111 LEROUX DR, DONIPHAN, MO 63935
(573) 996-2311
(573) 996-7415
Mailing address
111 LEROUX DR, DONIPHAN, MO 63935
(573) 996-2311
(573) 996-7415
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
11/20/2007
Last updated
05/23/2012
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