NPI 1780936963 · live from the CMS NPI Registry
Shopko Stores Operating Co LLC
Pharmacy, Community/Retail Pharmacy in Buffalo, WY. National Provider Identifier 1780936963, active.
NPI record
| NPI | 1780936963 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 129 Harmony St, Buffalo, WY 82834 |
| Practice phone | 307-684-4540 |
| Enumerated | October 11, 2012 |
| Last updated | February 12, 2013 |
| Authorized official | Michael Bettiga, Executive Vice President And Coo |
| Other names | Shopko Pharmacy 764 |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | — |
| Pharmacy | 333600000X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.