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Contact Information

SHOPKO STORES OPERATING CO LLC
598 LUCAS LANE
ELLSWORTH, WI54011
 Phone: 715-273-4466
 Fax: 715-273-5414
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SHOPKO STORES OPERATING CO LLC

NPI # 1609047869
LBN Legal business name SHOPKO STORES OPERATING CO LLC
Authorized official MICHAEL BETTIGA - (EXECUTIVE VICE PRESIDENT & COO)
Entity Organization
Organization subpart 1 No
Enumeration date 03/17/2008
Last updated 01/07/2013 - About 13 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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