SHOPKO STORES OPERATING CO., LLC (NPI# 1366828642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366828642 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO., LLC |
| Other Organization Name | SHOPKO PHARMACY #2799 |
| Practice Address |
440 W Main St Tremonton UT 84337 |
| Practice Telephone | 9204294726 |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-12-23 |
| Authorized Official Name | LORIE NEUMANN (DIR 3D PARTY CONTRACT & CA) |
| Authorized Official Telephone | 9204294726 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1366828642 | 05 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy #2799 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518320241 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 202 Susan Lawrence Drive, Ida Grove, IA 51445 | 2016-03-31 |
| 1659744720 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 1203 N Main St, Andrews, TX 79714-3630 | 2015-11-11 |
| 1801272182 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 471 Wine Country Road, Prosser, WA 99350 | 2015-08-10 |
| 1992181366 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 145 Broadway Ave N, Cokato, MN 55321 | 2015-08-07 |
| 1629452776 | Shopko Stores Operating Co., LLC | Pharmacy | 429 Michigan Ave, Orofino, ID 83544-0000 | 2015-07-17 |
| 1912398736 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 1026 S Challis St, Salmon, ID 83467-5441 | 2015-02-16 |
| 1225320419 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 106 Smith St, Bloomfield, IA 52537-2140 | 2011-05-06 |
| 1255864963 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | N2934 State Road 22, Wautoma, WI 54982-5267 | 2017-04-10 |
| 1003349101 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 100 County Road B, Shawano, WI 54166-7072 | 2017-04-05 |
| 1699089995 | Shopko Stores Operating Co., LLC | Pharmacy | 1345 S Frederick Ave, Oelwein, IA 50662-3060 | 2010-07-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Colorado Business Entities | ShopKo Stores Operating Co., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Iowa Business Entities | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Washington State Corporations | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304-5263 |
| Street Address |
440 W MAIN ST |
| City | TREMONTON |
| State | UT |
| Zip Code | 84337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134563760 | Jm Gauruder LLC | Chiropractor | 805 W Main St., Suite C, Tremonton, UT 84337 | 2013-04-25 |
| 1366717159 | Sean C Horsley | Social Worker | 905 N 1000 E, Tremonton, UT 84337 | 2012-03-13 |
| 1740420835 | Clifton Duane Kerr | General Practice | 725 West 1000 North, Tremonton, UT 84337 | 2009-03-02 |
| 1780877191 | Todd Miller | Family Medicine | 935 S 1000 W, Tremonton, UT 84337 | 2007-08-20 |
| 1982754081 | Bronson C Schultz | Dentist | 525 N 400 W, Tremonton, UT 84337 | 2007-01-11 |
| 1508423252 | Jeffrey David Zilles | Optometrist | 495 W 600 N, Tremonton, UT 84337 | 2019-05-28 |
| 1720330228 | Kristina C Gerlach | Social Worker | 440 W 600 N, Tremonton, UT 84337 | 2012-10-08 |
| 1295818664 | Dee Duncan | Psychologist | 881 N Tremont St, Tremonton, UT 84337-1025 | 2006-10-21 |
| 1730558792 | Sarah Hurst | Specialist/Technologist | 720 N 350 E, Tremonton, UT 84337-1040 | 2015-09-21 |
| 1184877052 | Our House of Tremonton | Assisted Living Facility | 429 N 400 W, Tremonton, UT 84337-1222 | 2008-10-23 |
| Find all providers in zip 84337 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912470246 | Ridley's Family Markets Inc | Pharmacy | 74 S 100 E, Tremonton, UT 84337-1606 | 2019-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1598371973 | Mountain West Medicine Inc. | Pharmacy | 1551 Renaissance Towne Dr Ste 104, Bountiful, UT 84010-7682 | 2020-09-21 |
| 1518577741 | Black Panda LLC | Pharmacy | 2507 S State St, Salt Lake City, UT 84115-3109 | 2020-08-03 |
| 1235751900 | Roe Rx Inc | Pharmacy | 145 S 3000 W, West Point, UT 84015 | 2020-05-15 |
| 1023637675 | Santaquin Market, Inc. | Pharmacy | 110 N. 400 E., Santaquin, UT 84655 | 2020-04-14 |
| 1891345237 | Strive Pharmacy Utah 1 LLC | Pharmacy | 8928 S State St, Sandy, UT 84070-2246 | 2019-09-17 |
| 1336705755 | Bear Lake Community Health Center | Pharmacy | 517 W 100 N Ste 210, Providence, UT 84332-9826 | 2019-05-10 |
| 1437620762 | Pthl LLC | Pharmacy | 1890 Bonanza Dr Ste 107, Park City, UT 84060-7217 | 2018-12-16 |
| 1093285785 | Richfield Community Pharmacy LLC | Pharmacy | 440 S Main St Ste B, Richfield, UT 84701-2855 | 2018-11-26 |
| 1265908719 | Salt Lake City Pharmacy LLC | Pharmacy | 6826 S Highland Dr, Cottonwood Heights, UT 84121-3021 | 2018-10-22 |
| Find all providers with the same taxonomy | ||||
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| 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.