Shopko Pharmacy 753

LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 753 is an health care organization with primary practice located at 2701 Highway 18 W , Hot Springs SD 57747-6601. 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 (605) 745-4681, or through Bettiga, Michael via phone (920) 429-4297.

Contact Information

Primary practice address
2701 Highway 18 W Hot Springs SD 57747-6601
Phone: (605) 745-4681
Fax: (605) 745-4813
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 1972556926
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as Shopko Pharmacy 753
Authorized official Bettiga, Michael RPH
Entity Organization
Organization subpart 1 No
Enumeration date May 19th, 2006
Last updated Oct 18th, 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 1972556926 NPPES
Wyoming MEDICAID 123292401
Wyoming MEDICAID 9162102
Wyoming Other 4304630
Wyoming MEDICAID 8502040
Wyoming MEDICAID 117793100
Wyoming MEDICAID 47062642602
Wyoming MEDICAID 9566672
Wyoming MEDICAID 10025418100
Wyoming MEDICAID 123292400
Wyoming MEDICAID 8502042

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