Organization · Type 2 NPI

Shopko Stores Operating Co LLC

Durable Medical Equipment & Medical Supplies · Doniphan, MO

NPI number 1386825248 Active

Practice location

111 Leroux Dr
Doniphan, MO 63935

Fax (573) 996-7415

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies Primary	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy	3336C0003X	None listed

Durable Medical Equipment & Medical Supplies: A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Other durable medical equipment & medical supplies providers in Doniphan

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NPI record

NPI: 1386825248
Entity type: Organization (Type 2)
Issued: Nov 20, 2007
Last updated: May 23, 2012
Status: Active
Subpart: Yes of Shopko Pharmacy 706

Other names

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Shopko Pharmacy 706 · doing business as

Authorized official

Michael Bettiga, RPH
Excutive Vice President & COO
(920) 429-4297

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1386825248

Shopko Stores Operating Co LLC's National Provider Identifier is 1386825248, issued on Nov 20, 2007. The primary taxonomy on file is Durable Medical Equipment & Medical Supplies (332B00000X), and the practice location is in Doniphan, MO. The record was last updated on May 23, 2012.