Organization
SHOPKO STORES OPERATING CO LLC
Active
Other names
Shopko Pharmacy 626
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
1625 US HIGHWAY 61, LANCASTER, WI 53813-9448
(608) 723-7679
(608) 723-6202
Mailing address
1625 US HIGHWAY 61, LANCASTER, WI 53813-9448
(608) 723-7679
(608) 723-6202
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
—
33238300
—
WI
01
—
5124893
NCPDP
—
Enumeration date
05/23/2006
Last updated
09/13/2012
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