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Organization

SHOPKO INSTITUTIONAL CARE SERVICES CO LLC

Active
Other names
Shopko RxCare
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL BETTIGA RPH (EXECUTIVE VICE PRESIDENT AND COO)
(920) 429-4297
Entity
Organization

Contact information

Practice address
3184 LONDON RD, EAU CLAIRE, WI 54701-6834
(715) 832-3780
(715) 832-3766
Mailing address
3184 LONDON RD, EAU CLAIRE, WI 54701-6834

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1811235781
WI
01
5133513
NCPDP
WI
01
9191-42
LICENSE
Enumeration date
01/28/2013
Last updated
03/07/2023
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