SHOPKO STORES OPERATING CO LLC (NPI# 1588845929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588845929 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 701 |
| Practice Address |
1212 W Main Lyons KS 67554 |
| Mailing Address |
1212 W Main St Lyons KS 67554-2428 |
| Practice Telephone | 6202572821 |
| Practice Fax Number | 6202572207 |
| Mailing Telephone | 6202572821 |
| Mailing Fax Number | 6202572207 |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2013-01-29 |
| Authorized Official Name | MR. MICHAEL BETTIGA (EXECUTIVE VICE PRESIDENT AND COO) |
| Authorized Official Telephone | 9204294297 |
| Authorized Official Credential | RPH |
| 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 |
|---|---|---|---|
| KS | 200389320K | 05 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy 701 | Doing Business As Name - Organization |
| 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 |
| Street Address |
1212 W MAIN |
| City | LYONS |
| State | KS |
| Zip Code | 67554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205308053 | Lyon Pharmacy Inc | Pharmacy | 921 W Main St, Lyons, KS 67554 | 2018-12-18 |
| 1972005494 | Teresa M Cordell | Chiropractor | 108 W Commercial St, Lyons, KS 67554 | 2018-02-28 |
| 1649482282 | Grene Vision Group LLC | Ophthalmology | 111 West First, Lyons, KS 67554 | 2007-05-04 |
| 1497245005 | Cordell Chiropractic Clinic LLC | Chiropractor | 108 W Commercial St, Lyons, KS 67554 | 2018-05-18 |
| 1427145739 | Hospital District No 1 of Rice Co | Medicare Defined Swing Bed Unit | 619 S Clark Ave, Lyons, KS 67554 | 2006-10-06 |
| 1710962014 | Hospital District No 1 of Rice Co | General Acute Care Hospital | 619 S. Clark, Lyons, KS 67554-0828 | 2005-12-08 |
| 1043828163 | Jacob Edwards | Pharmacist | 921 W Main St, Lyons, KS 67554-1708 | 2020-07-15 |
| 1114535226 | Ashlyn Raye Hammer | Pharmacist | 921 W Main St, Lyons, KS 67554-1708 | 2020-07-15 |
| 1700409802 | Ludwig Family Chiropractic LLC | Chiropractor | 400 W Main St, Lyons, KS 67554-1819 | 2020-05-22 |
| 1245876663 | Naomi Aiko Patrnchak | Chiropractor | 400 W Main St, Lyons, KS 67554-1819 | 2019-11-20 |
| Find all providers in zip 67554 | ||||
| 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 |
|---|---|---|---|---|
| 1790790913 | Walgreen Co | Pharmacy | 4101 1st Ave, Lyons, IL 60534-1028 | 2006-07-29 |
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| 1174132161 | Ascension Via Christi Hospitals Wichita Inc. | Pharmacy | 3600 E Harry St Rm 2001, Wichita, KS 67218-3713 | 2020-07-27 |
| 1932724481 | Mt Oread Pharmacy LLC | Pharmacy | 6265 Rock Chalk Drive, Lmh Health West, Suite 1401, Lawrence, KS 66049 | 2020-06-10 |
| 1174143309 | Central Care, Pa | Pharmacy | 8919 Parallel Pkwy Ste 250, Kansas City, KS 66112-1655 | 2020-04-17 |
| 1942829916 | Sharon Lee Family Health Care, Inc | Pharmacy | 2002 S 51st St, Kansas City, KS 66106-2419 | 2020-04-10 |
| 1629617188 | Leekers Valley Center Inc | Pharmacy | 225 S Meridian, Valley Center, KS 67147 | 2020-01-02 |
| 1811536683 | Active Lifestyle Pharmacy LLC | Pharmacy | 7800 Foster St, Overland Park, KS 66204-2955 | 2019-12-27 |
| 1427694611 | Free State Pharmacy LLC | Pharmacy | 3200 Haskell Ave Ste 140, Lawrence, KS 66046-8945 | 2019-11-21 |
| 1588224315 | Gail Reif Inc. | Pharmacy | 2040 Hutton Rd Ste 101, Kansas City, KS 66109-4566 | 2019-06-14 |
| 1356807044 | Dandurand Wellness, Inc. | Pharmacy | 550 N Hillside St Ste 3-100, Wichita, KS 67214-4910 | 2019-02-18 |
| 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.