SHOPKO STORES OPERATING CO LLC (NPI# 1821041641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821041641 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 774 |
| Practice Address |
100 Washington St Livingston MT 59047-4200 |
| Practice Telephone | 4062227082 |
| Practice Fax Number | 4062227086 |
| Mailing Telephone | 4062227082 |
| Mailing Fax Number | 4062227086 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2012-11-20 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 1821041641 | 05 | |
| NCPDP | 2704636 | 01 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy 774 | 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 |
100 WASHINGTON ST |
| City | LIVINGSTON |
| State | MT |
| Zip Code | 59047-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013578343 | Sara Gentry | Social Worker | 126 East Callendar Suite 5, Livingston, MT 59047 | 2019-06-26 |
| 1972099752 | Lisa Talcott LLC | Social Worker | 410 S. 11th St, Livingston, MT 59047 | 2018-07-05 |
| 1326535071 | Christine Evelyn May | Counselor | 320 N Main St Ste 2, Livingston, MT 59047 | 2018-04-18 |
| 1033617469 | Lisa Talcott | Social Worker | 410 S. 11th St., Livingston, MT 59047 | 2018-01-31 |
| 1821492125 | Kim Salloux Lac | Preferred Provider Organization | 109 W Callender Suite 2e, Livingston, MT 59047 | 2014-10-15 |
| 1043657752 | Jamie Lynn Van Zee | Speech-Language Pathologist | 80 West Pine Creek, Livingston, MT 59047 | 2013-06-04 |
| 1598051039 | Emma Taylor Neal | Occupational Therapist | 608 E Milky Way Dr, Livingston, MT 59047 | 2011-06-23 |
| 1063715985 | Jacqueline K Isaly | Counselor | 430 E Park, Livingston, MT 59047 | 2010-12-15 |
| 1063665768 | Danny F. Neill | Hearing Instrument Specialist | 615 W. Park St., Livingston, MT 59047 | 2008-10-28 |
| 1093971376 | Kevin Graham Scott | Dentist | 422 South Main Street, Livingston, MT 59047 | 2008-08-05 |
| Find all providers in zip 59047 | ||||
| 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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| 1073175675 | Livingston Community Health | Pharmacy | 600 B St Ste B, Livingston, CA 95334-9593 | 2019-07-03 |
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| 1538685458 | Thrift Town Drugs LLC | Pharmacy | 29680 S Frost Rd, Livingston, LA 70754 | 2017-08-22 |
| 1699010785 | Rx Team Inc | Pharmacy | 91 E Mount Pleasant Ave, Livingston, NJ 07039-3005 | 2012-11-30 |
| 1982838934 | Lopers Neighborhood Pharmacy Inc | Pharmacy | 1934 U S Highway 190 W, Livingston, TX 77351-9600 | 2009-05-06 |
| 1154599066 | Aleran Holdings LLC | Pharmacy | 365 E Northfield Rd, Livingston, NJ 07039-4810 | 2008-02-13 |
| 1083706550 | New Jersey Cvs Pharmacy LLC | Pharmacy | 184 S Livingston Ave Cedar Mall, Livingston, NJ 07039 | 2006-09-29 |
| 1306941927 | J & A Pharmacy Services LLC | Pharmacy | 365 E Northfield Road, Livingston, NJ 07039 | 2006-09-14 |
| Find all providers in LIVINGSTON | ||||
| City | LIVINGSTON |
| Zip Code | 59047 |
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.