SHOPKO INSTITUTIONAL CARE SERVICES CO LLC NPI 1053621243

NPI Information

SHOPKO INSTITUTIONAL CARE SERVICES CO LLC is a long term care pharmacy pharmacy in Appleton, WI. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. SHOPKO INSTITUTIONAL CARE SERVICES CO LLC NPI is 1053621243. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Rxcare.

The provider's business location address is:

3701 E EVERGREEN DR
STE 1000
APPLETON, WI
ZIP 54913-402
Phone: (920) 739-7855
Fax: (920) 739-3922

The provider's authorized official is Michael Bettiga .
The authorized official title is Executive Vice President And Coo and has the following contact phone number (920) 429-4297.

The enumeration date for this NPI number is 10/21/2010 and was last updated on 11/1/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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