Shopko Stores Operating Co LLC
Shopko Stores Operating Co LLC is a Durable Medical Equipment & Medical Supplies in Jacksonville, Illinois. Licensed in Illinois. Registered with an NPI since 2006.
- Licensed in
- IL
- In the registry since
- 2006
- Specialties on file
- 3
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1964 W Morton AveJacksonville, IL 62650-2621
Phone: (217) 245-6259
Fax: (217) 243-9251
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community/Retail Pharmacy (primary) | Taxonomy 3336C0003X · Licence 054015893 (IL) |
|---|---|
| Durable Medical Equipment & Medical Supplies | Taxonomy 332B00000X |
| Eyewear Supplier | Taxonomy 332H00000X |
Record details
| NPI number | 1912933961 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297 |
| Other names | Shopko Pharmacy 140 |
| NPI enumerated | June 23, 2006 |
| Last updated in NPPES | May 22, 2014 |
| Mailing address | 1964 W Morton Ave, Jacksonville, IL 62650-2621 |
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