Shopko Stores Operating Co LLC
Pharmacy, Community/Retail Pharmacy in Grand Island, NE. Organization (NPI-2).
NPI number1790736072
StatusActive
Last updated in NPPESDec 21, 2015
Details
- NPI
- 1790736072
- Entity type
- Organization (NPI-2)
- Legal business name
- Shopko Stores Operating Co LLC
- Organization subpart
- No
- Enumeration date
- May 12, 2006
- Last updated
- Dec 21, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 2676 | NE | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – |
Other names
- Shopko Pharmacy 038 (Doing Business As)
Practice location
2208 N Webb RdGrand Island, NE 68803-1739
Phone 308-382-6744 · Fax 308-381-8401
Mailing address
2208 N Webb RdGrand Island, NE 68803-1739
Phone 308-382-6744 · Fax 308-381-8401
Authorized official
Russell Steinhorst
Svp Chief Financial Officer
9204297489
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