SHOPKO STORES OPERATING CO LLC


Address: 300 Jake St, Perham, MN 56573
Phone: 2183467751

SHOPKO STORES OPERATING CO LLC (NPI# 1023063757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023063757
Entity Type Organization
Organization Name SHOPKO STORES OPERATING CO LLC
Other Organization Name SHOPKO PHARMACY 738
Practice Address 300 Jake St
Perham
MN 56573
Mailing Address Po Box 10
Perham
MN 56573-0010
Practice Telephone 2183467751
Practice Fax Number 2183467752
Mailing Telephone 2183467751
Mailing Fax Number 2183467752
Enumeration Date 2006-05-23
Last Update Date 2012-09-24
Authorized Official Name MR. MICHAEL BETTIGA (EXECUTIVE VICE PRESIDENT & COO)
Authorized Official Telephone 9204294297
Authorized Official Credential RPH
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 333600000X Pharmacy Suppliers
N 332B00000X Durable Medical Equipment & Medical Supplies Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NCPDP 2421511 01
MN 300559300 05
MN 208187000 05

Other Provider/Organization Names

Other Name Type Code
Shopko Pharmacy 738 Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1275017907 Shopko Stores Operating Co LLC Eyewear Supplier (Equipment, not the service) 1166 W Sunset Drive, Suite F100, Waukesha, WI 53189 2018-09-19
1871076968 Shopko Stores Operating Co LLC Eyewear Supplier (Equipment, not the service) 1810 Jackson St, Oshkosh, WI 54901-2204 2018-09-13
1427547082 Shopko Stores Operating Co LLC Eyewear Supplier (Equipment, not the service) 10996 N Port Washington Rd, Mequon, WI 53092 2018-05-08
1912454505 Shopko Stores Operating Co LLC Durable Medical Equipment & Medical Supplies 908 Nw 6th St, Tulia, TX 79088 2016-09-01
1821545419 Shopko Stores Operating Co LLC Durable Medical Equipment & Medical Supplies 67 Selkirk Way, Oldtown, ID 83822 2016-09-01
1740736586 Shopko Stores Operating Co LLC Durable Medical Equipment & Medical Supplies 94 North 400 East, Delta, UT 84624 2016-08-31
1639625064 Shopko Stores Operating Co LLC Pharmacy 1001 N Center Ave, Hardin, MT 59034-1101 2016-08-26
1649726076 Shopko Stores Operating Co LLC Durable Medical Equipment & Medical Supplies 1635 E Highway 40, Ballard, UT 84066-5217 2016-08-26
1841745155 Shopko Stores Operating Co LLC Durable Medical Equipment & Medical Supplies 301 E Us Highway 20, Gordon, NE 69343-1650 2016-08-17
1821441205 Shopko Stores Operating Co LLC Durable Medical Equipment & Medical Supplies 6355 Main St, Bonners Ferry, ID 83805-8519 2016-07-20

Office Location

Street Address 300 JAKE ST
City PERHAM
State MN
Zip Code 56573

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1558630012 Perham Hospital District Durable Medical Equipment & Medical Supplies 1000 Coney Street West, Perham, MN 56573 2011-12-29
1730239385 Dr. Kelvin K. Salathe, P.C. Chiropractor 101 West Coney St, Perham, MN 56573 2007-01-12
1124106299 Langen Family Chiropractic, P.a. Chiropractor 108 Market Dr., Perham, MN 56573 2006-11-02
1285710335 James Odin Langen Chiropractor 108 Market Drive, Perham, MN 56573 2006-10-31
1578572202 Michael L Hamann Dentist 200 1st Ave S, Perham, MN 56573 2006-08-05
1033133517 Timothy Charles Neitzke Optometrist 340 Fox St, Perham, MN 56573 2006-07-27
1164917233 Katlin Larson Behavior Technician 735 3rd St Sw, Perham, MN 56573 2018-06-29
1104029347 Tammy L Sturdevant Dentist 335 4th Ave, Perham, MN 56573 2007-06-06
1861610131 Minnesota Eyecare Network Inc. Eyewear Supplier (Equipment, not the service) 340 Fox Street, Perham, MN 56573 2007-04-23
1194793562 Richard W Masur Emergency Medicine 665 3rd St Sw, Perham, MN 56573-1108 2006-03-10
Find all providers in zip 56573

Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1497368633 Sawtooth Mountain Clinic, Inc. Pharmacy 513 5th Ave W Rm 201, Grand Marais, MN 55604-3017 2020-08-27
1891313326 Rochester Community Pharmacy LLC Pharmacy 1604 1st St Nw, Rochester, MN 55901-0318 2020-07-10
1134745730 Elko New Market Family Pharmacy, LLC Pharmacy 117 Old Town Road, Elko New Market, MN 55054 2020-06-19
1578187456 Coborns Inc Pharmacy 15700 88th St Ne, Otsego, MN 55330 2020-06-05
1205460169 Genoa Healthcare, LLC Pharmacy 1515 Energy Park Dr Ste 110, Saint Paul, MN 55108-5229 2020-02-28
1801438361 The Duluth Clinic, Ltd. Pharmacy 2 Division St Ste A, Deer River, MN 56636-8779 2019-10-16
1265084792 Nudak Ventures, LLC Pharmacy 5418 Saint Croix Trl, North Branch, MN 55056-4203 2019-07-15
1659938116 Sterlingrx Inc Pharmacy 1312 Northland Dr Ste 500, Mendota Heights, MN 55120-1436 2019-05-21
1639734346 Seward Pharmacy LLC Pharmacy 2209 E Lake St, Minneapolis, MN 55407-4563 2019-05-08
1093370694 Minnesota Ave N Pharmacy Services Limited Pharmacy 226 Minnesota Ave N, Aitkin, MN 56431-1412 2019-05-08
Find all providers with the same taxonomy

Competitor

Search similar providers

City PERHAM
Zip Code 56573

Improve Information

Please comment or provide details below to improve the information on SHOPKO STORES OPERATING CO LLC.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches