Shopko Pharmacy 096
LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 096 is an health care organization with primary practice located at 55 Lake Blvd , Redding CA 96003-2500. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty.
Shopko Stores Operating Co Llc can be contacted via phone (530) 241-0713, or through Bettiga, Michael J via phone (920) 429-4297.
Contact Information
Primary practice address
55 Lake Blvd
Redding CA 96003-2500
Phone: (530) 241-0713
Fax: (530) 241-1447
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY47484 | California |
Profile Details
| NPI number | 1659316107 |
|---|---|
| LBN Legal business name | Shopko Stores Operating Co Llc |
| DBA Doing business as | Shopko Pharmacy 096 |
| Authorized official | Bettiga, Michael J RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 18th, 2006 |
| Last updated | Aug 14th, 2008 - about 16 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 | 1659316107 | NPPES |
| California | MEDICAID | MFGPHA376480 | |
| California | MEDICAID | PHA376480 | |
| California | Other | 0598194 | |
| California | MEDICAID | 1ZXPHA358300 | |
| California | MEDICAID | PHA474840 | |
| California | MEDICAID | QN4PHA474840 |
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