SHOPKO STORES OPERATING CO LLC (NPI# 1821441205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821441205 |
Entity Type | Organization |
Organization Name | SHOPKO STORES OPERATING CO LLC |
Other Organization Name | SHOPKO PHARMACY 584 |
Practice Address |
6355 Main St Bonners Ferry ID 83805-8519 |
Practice Telephone | 9204294726 |
Mailing Telephone | 9204294726 |
Enumeration Date | 2016-07-20 |
Last Update Date | 2016-12-08 |
Authorized Official Name | LORIE NEUMANN (DIRECTOR OF THIRD PARTY) |
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 |
Other Name | Type Code |
---|---|
SHOPKO PHARMACY 584 | 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 |
1184073520 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 3402 Main St, Emmetsburg, IA 50536-1515 | 2016-06-07 |
Street Address |
6355 MAIN ST |
City | BONNERS FERRY |
State | ID |
Zip Code | 83805-8519 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366990996 | Nicole Diana Madill | Counselor | 687 Cody Street, Bonners Ferry, ID 83805 | 2016-09-12 |
1154770295 | Rachel Meiland Webster | Social Worker | 6686 Augusta Bldg 100, Bonners Ferry, ID 83805 | 2016-06-09 |
1205211786 | Robert Rossi | Social Worker | Kaniksu Health Services, 6615 Comanche St, Bonners Ferry, ID 83805 | 2015-07-24 |
1154660041 | Mark R. Barker, O.d.p.c. | Optometrist | 7177 Main St., Bonners Ferry, ID 83805 | 2013-02-12 |
1003182668 | Jessica Faye Horricks | Dentist | 6615 Commanche, Bonners Ferry, ID 83805 | 2012-03-28 |
1427334929 | Tanya Marie Allmaras | Physician Assistant | 6635 Comanche Street, Bonners Ferry, ID 83805 | 2011-10-27 |
1114259769 | Joshua Olen Shelton | Chiropractor | 6389 Bonner St., Bonners Ferry, ID 83805 | 2010-02-08 |
1558690644 | April C Christman | Social Worker | 6615 Comanche Street, Bonners Ferry, ID 83805 | 2009-12-18 |
1407006067 | Denys Taipale-knight | Counselor | 385 Moose Ridge Lane, Bonners Ferry, ID 83805 | 2008-09-19 |
1013126457 | John Pierce Brownlee Jr. | Registered Nurse | 6640 Kaniksu Street, Boundary Community Hospital, Bonners Ferry, ID 83805 | 2007-05-22 |
Find all providers in zip 83805 |
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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1043838584 | Costco Wholesale Corporation | Pharmacy | 3403 W Chinden Blvd, Meridian, ID 83646-7151 | 2020-07-10 |
1265054324 | Costco Wholesale Corporation | Pharmacy | 2495 E Lincoln Rd, Idaho Falls, ID 83401-2203 | 2020-05-12 |
1851923544 | Rocky Mountain Pharmacy, LLC | Pharmacy | 3910 Washington Pkwy Ste A, Idaho Falls, ID 83404-7884 | 2020-02-10 |
1013559269 | Timberline Pharmacy | Pharmacy | 4574 N Ten Mile Rd Ste 110, Meridian, ID 83646-6930 | 2019-10-09 |
1508420373 | K2red LLC | Pharmacy | 447 N Idaho St, Wendell, ID 83355 | 2019-04-27 |
1679039135 | Hollis Family Pharmacy LLC | Pharmacy | 845 S Substation Rd, Emmett, ID 83617 | 2019-02-20 |
1598229809 | Clearwater Canyon Pharmacy, LLC | Pharmacy | 13020 Us-12, Orofino, ID 83544 | 2019-01-31 |
1861999377 | Bi-mart Corporation | Pharmacy | 11347 W State Street, Star, ID 83669 | 2018-04-11 |
Find all providers with the same taxonomy |
City | BONNERS FERRY |
Zip Code | 83805 |
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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.