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Organization

SHOPKO STORES OPERATING CO LLC

Active
Other names
SHOPKO PHARMACY #2205
Organization subpart
No

Provider details

NPI number
Authorized official
LORIE NEUMANN (DIRECTOR OF THIRD PARTY)
92044294726
Entity
Organization

Contact information

Practice address
94 NORTH 400 EAST, DELTA, UT 84624
(920) 429-4726
Mailing address
94 NORTH 400 EAST, DELTA, UT 84624
(920) 429-4726

Taxonomy

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

Other

Enumeration date
08/31/2016
Last updated
11/15/2016
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