SHOPKO STORES OPERATING CO LLC (NPI# 1619921343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619921343 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 661 |
| Practice Address |
500 Plaza Drive West Point NE 68788-1835 |
| Mailing Address |
Po Box 1450 Minneapolis MN 55485-5891 |
| Practice Telephone | 4023725655 |
| Practice Fax Number | 4023724966 |
| Mailing Telephone | 4023725655 |
| Mailing Fax Number | 4023724966 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2012-08-21 |
| Authorized Official Name | MR. MICHAEL BETTIGA (EXECUTIVE VICE PRESIDENT & 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 |
|---|---|---|---|
| MEDICARE ID - TYPE UNSPECIFIED | 0459230137 | 01 | |
| NCPDP | 2817015 | 01 | |
| NE | 10025232900 | 05 | |
| NE | 10025416600 | 05 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy 661 | 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 |
500 PLAZA DRIVE |
| City | WEST POINT |
| State | NE |
| Zip Code | 68788-1835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619458023 | Amy K Schantz | Counselor | 221 E Grant Street, West Point, NEBRASKA 68788 | 2018-08-23 |
| 1699829903 | Nichole A. Chambliess | Occupational Therapist | 430 N. Monitor St., St. Francis Hospital, West Point, NE 68788 | 2007-01-23 |
| 1447326889 | Frank J Kowal | Dentist | 212 So Main St, General Practice, West Point Nebr, NE 68788 | 2006-11-28 |
| 1639638067 | Christa Carr | Pharmacist | 303 Plaza Dr, West Point, NE 68788 | 2019-03-15 |
| 1093250631 | Tessa Recker | Speech-Language Pathologist | 1200 E Washington St, West Point, NE 68788 | 2017-01-05 |
| 1023415700 | Julie Ann Neiman | Occupational Therapist | 960 Prospect Rd, West Point, NE 68788 | 2014-11-25 |
| 1568546950 | David Mlnarik | Dentist | 910 N Lincoln St, West Point, NE 68788-1002 | 2006-10-24 |
| 1235511213 | Kralik Dakota Dental, P.C. | Clinic/Center | 910 N Lincoln St, West Point, NE 68788-1002 | 2015-06-25 |
| 1891955522 | Jesse D Carr | Dentist | 910 N Lincoln St, West Point, NE 68788-1002 | 2008-06-16 |
| 1821173204 | Shawn Kralik | Dentist | 910 N Lincoln St, West Point, NE 68788-1002 | 2006-10-26 |
| Find all providers in zip 68788 | ||||
| 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] |
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| 1629552385 | West Point Pharmacy | Pharmacy | 3024 W 300 N Ste D, West Point, UT 84015-7259 | 2018-09-19 |
| 1972945780 | Point City Drugs LLC | Pharmacy | 7683 Highway 45 Alt N, West Point, MS 39773 | 2013-07-22 |
| 1215026257 | West Point Pharmacy Inc | Pharmacy | 1302-a Lee St, West Point, VA 23181-1463 | 2006-10-11 |
| 1235235722 | West Point Medical Center Pharmacy, Inc | Pharmacy | 721 Medical Center Dr, West Point, MS 39773-9318 | 2006-09-15 |
| 1831710441 | Franciscan Care Services Inc | Pharmacy | 430 N Monitor St, West Point, NE 68788-1595 | 2020-05-05 |
| 1588129720 | Pender Care Centre District Inc | Pharmacy | 303 Plaza Dr, West Point, NE 68788-2611 | 2019-02-01 |
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| 1245852185 | Service Drugs, Inc. | Pharmacy | 202 Main St., Crawford, NE 69339-1026 | 2020-05-14 |
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| 1952960783 | Lincoln Pharmacy LLC | Pharmacy | 3300 A Street, Ste 100, Lincoln, NE 68510-4512 | 2019-06-06 |
| 1457819922 | Providence Medical Center | Pharmacy | 803 Providence Rd Ste 101, Wayne, NE 68787-1590 | 2019-03-04 |
| 1801374491 | Walnut Creek LLC | Pharmacy | 11020 Q Street, Omaha, NE 68137 | 2018-08-06 |
| 1992283584 | Rainwood Rx LLC | Pharmacy | 20513 Nicholas Circle, Ste 3, Elkhorn, NE 68022 | 2018-08-06 |
| 1083128250 | Innovative Pain & Spine Specialists | Pharmacy | 7121 Stephanie Ln Ste 104, Lincoln, NE 68516-5359 | 2017-11-27 |
| 1225547433 | Costco Wholesale Corportation | Pharmacy | 1620 Pine Lake Road, Lincoln, NE 68512 | 2017-09-20 |
| 1699191734 | Arborpharm, LLC | Pharmacy | 203 S 7th St, Ste B, Wymore, NE 68466 | 2014-03-13 |
| 1982020590 | B&r Stores, Inc | Pharmacy | 611 N Burlington Ave, Hastings, NE 68901-5037 | 2014-03-07 |
| Find all providers with the same taxonomy | ||||
| City | WEST POINT |
| Zip Code | 68788 |
Please comment or provide details below to improve the information on SHOPKO STORES OPERATING CO LLC.
| 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.