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Organization

SHOPKO STORES OPERATING CO., LLC

Active
Other names
Shopko Pharmacy #2554
Organization subpart
No

Provider details

NPI number
Authorized official
LORIE NEUMANN (DIR 3D PARTY CONTRACT & CA)
(920) 429-4726
Entity
Organization

Contact information

Practice address
1203 N MAIN ST, ANDREWS, TX 79714-3630
(432) 523-3302
Mailing address
1203 N MAIN ST, ANDREWS, TX 79714-3630

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
11/11/2015
Last updated
11/11/2015
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