Shopko Pharmacy 113

LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 113 is an health care organization with primary practice located at 5500 Martin Way E , Lacey WA 98516-6326. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Shopko Stores Operating Co Llc can be contacted via phone (360) 456-4057, or through Bettiga, Michael J via phone (920) 429-4297.

Contact Information

Primary practice address
5500 Martin Way E Lacey WA 98516-6326
Fax: (360) 456-0903
Website:
Authorized official contact:
Name: Bettiga, Michael J RPH

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X CF00058640 Washington

Profile Details

NPI number 1962442392
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as Shopko Pharmacy 113
Authorized official Bettiga, Michael J RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jun 7th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962442392 NPPES
Washington MEDICAID 0006013270
Washington Other 0215810
Washington Other 0047611
Washington Other 4923175

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