Shopko Stores Operating Co LLC
Pharmacy, Community/Retail Pharmacy in Hodgenville, KY. Organization (NPI-2).
NPI number1114979531
StatusActive
Last updated in NPPESFeb 8, 2013
Details
- NPI
- 1114979531
- Entity type
- Organization (NPI-2)
- Legal business name
- Shopko Stores Operating Co LLC
- Organization subpart
- No
- Enumeration date
- May 16, 2006
- Last updated
- Feb 8, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 333600000X | Pharmacy | – | – |
Other names
- Shopko Pharmacy 730 (Doing Business As)
Practice location
657 W Main StHodgenville, KY 42748-1569
Phone 270-358-4391 · Fax 270-358-4682
Mailing address
657 W Main StHodgenville, KY 42748-1569
Phone 270-358-4391 · Fax 270-358-4682
Authorized official
Michael Bettiga
Executive Vice President & Coo
9204294297
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