Shopko Pharmacy 102
LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 102 is an health care organization with primary practice located at 2741 Roosevelt Rd , Marinette WI 54143-3833. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Eyewear Supplier (Equipment, not the service), Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Shopko Stores Operating Co Llc can be contacted via phone (715) 735-0325, or through Bettiga, Michael J via phone (920) 429-4297.
Contact Information
Primary practice address
2741 Roosevelt Rd
Marinette WI 54143-3833
Phone: (715) 735-0325
Fax: (715) 735-0111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 8600042 | Wisconsin |
Profile Details
| NPI number | 1477509826 |
|---|---|
| LBN Legal business name | Shopko Stores Operating Co Llc |
| DBA Doing business as | Shopko Pharmacy 102 |
| Authorized official | Bettiga, Michael J RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 26th, 2006 |
| Last updated | Jun 6th, 2014 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477509826 | NPPES |
| Wisconsin | MEDICAID | 33171000 | |
| Wisconsin | MEDICAID | 4913409 | |
| Wisconsin | MEDICAID | 2653481 | |
| Wisconsin | Other | 5120148 | |
| Wisconsin | MEDICAID | 5120148 |
Popular Providers
-
Wal-Mart Stores East Lp
2900 Roosevelt Rd , Marinette WI 54143-4299 -
Bioscrip Pharmacy, Inc.
3900 Fifth Ave Ste 110, San Diego CA 92103-3122 -
Princeton Drug
105 Broyles Dr , Johnson City TN 37601-2542 -
Aurora Pharmacy Inc
4061 Old Peshtigo Rd , Marinette WI 54143 -
Walgreen Co
2301 Hall Ave , Marinette WI 54143-1236 -
Bioscrip Pharmacy, Inc.
342 Massachusetts Ave Ste 103, Indianapolis IN 46204-2192 -
Bay Area Medical Center Inc
3100 Shore Dr- Suite Cos, Marinette WI 54143-4242 -
Bioscrip Pharmacy, Inc.
8490 Santa Monica Blvd Ste 1, West Hollywood CA 90069-4261