Shopko Pharmacy 755

LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 755 is an health care organization with primary practice located at 1701 16Th St , Wheatland WY 82201-2243. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, 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 (307) 322-2030, or through Bettiga, Michael via phone (920) 429-4297.

Contact Information

Primary practice address
1701 16Th St Wheatland WY 82201-2243
Phone: (307) 322-2030
Fax: (307) 322-2082
Website:
Map and Directions
Authorized official contact:
Name: Bettiga, Michael RPH
Phone: (920) 429-4297

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1851330740
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as Shopko Pharmacy 755
Authorized official Bettiga, Michael RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jun 6th, 2006
Last updated Oct 15th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851330740 NPPES
Wyoming MEDICAID 123289401
Wyoming MEDICAID 123289400
Wyoming MEDICAID 111696700
Wyoming Other 5203168

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