Organization
SHOPKO STORES OPERATING CO LLC
Active
Other names
Shopko Pharmacy 2656
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL STEINHORST (EVP AND CFO)
(920) 429-7489
Entity
Organization
Contact information
Practice address
748 S CEDAR ST STE E, KALKASKA, MI 49646-8434
(231) 258-0139
(231) 258-5488
Mailing address
748 S CEDAR ST STE E, KALKASKA, MI 49646-8434
(231) 258-0139
(231) 258-5488
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
—
2370598
—
MI
Enumeration date
12/18/2007
Last updated
12/15/2015
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