Organization
SHOPKO STORES OPERATING CO LLC
Active
Other names
Shopko Pharmacy 513
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
107 NORTH MAIN, EVART, MI 49631
(231) 734-5581
(231) 734-6170
Mailing address
107 NORTH MAIN, EVART, MI 49631
(231) 734-5581
(231) 734-6170
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
—
2370459
—
MI
Enumeration date
10/31/2007
Last updated
02/18/2013
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