SHOPKO STORES OPERATING CO LLC
101 S Polk St
Albany, MO 64402
660-726-3154
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 332B00000X | Suppliers - Durable Medical Equipment & Medical Supplies - | ||
N | 333600000X | Suppliers - Pharmacy | ||
Y | 3336C0003X | Suppliers - Pharmacy |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
621586403 | MO | MEDICAID | |
NCPDP | 2635540 | OTHER | |
601586407 | MO | MEDICAID |