SHOPKO STORES OPERATING CO LLC (NPI# 1891741245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891741245 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 029 |
| Practice Address |
7401 Mineral Point Rd Madison WI 53717 |
| Mailing Address |
7401 Mineral Point Rd Madison WI 53717-1703 |
| Practice Telephone | 6088336622 |
| Practice Fax Number | 6088332275 |
| Mailing Telephone | 6088336622 |
| Mailing Fax Number | 6088332275 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2018-06-08 |
| Authorized Official Name | DILIP SEDANI (VP) |
| Authorized Official Telephone | 9204297688 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
8595042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33025400 | 05 | |
| NCPDP NUMBER | 5115262 | 01 |
| Other Name | Type Code |
|---|---|
| ShopKo Pharmacy 029 | 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 |
7401 MINERAL POINT RD |
| City | MADISON |
| State | WI |
| Zip Code | 53717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346292745 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 7401 Mineral Point Rd, Madison, WI 53717 | 2006-05-16 |
| 1740625862 | Cynthia Eileen Liebau | Pharmacist | 7401 Mineral Point Rd, Madison, WI 53717-1703 | 2013-05-02 |
| 1497933410 | Beata Malgorzata Nowak | Pharmacist | 7401 Mineral Point Rd, Shopko Pharmacy, Madison, WI 53717-1703 | 2008-01-31 |
| 1255518676 | Martha Lee Girdaukas | Pharmacist | 7401 Mineral Point Rd, Madison, WI 53717-1703 | 2008-01-28 |
| 1154366847 | James Michael Rewey | Physician Assistant | 7401 Mineral Point Rd, Madison, WI 53715-1596 | 2006-06-18 |
| 1932151313 | Ken Thue | Optometrist | 7401 Mineral Point Rd, Madison, WI 53717-1703 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720540164 | Apex Chiropractic Center LLC | Chiropractor | 562 Junction Road, Madison, WI 53717 | 2019-04-04 |
| 1467943795 | Brittany Macrander | Speech-Language Pathologist | 701 Deming Way, Madison, WI 53717 | 2018-05-22 |
| 1144622614 | Christopher Leclair | Pharmacist | 7942 Tree Ln, Suite 201, Madison, WI 53717 | 2014-09-16 |
| 1740617430 | Martha Darlene Kniffin | Marriage & Family Therapist | 1805 Excelsior Dr, The Family Center, Madison, WI 53717 | 2013-09-26 |
| 1740538305 | Amber J Thompson | Specialist | 8202 Excelisor Dr, Madison, WI 53717 | 2012-08-29 |
| 1457622938 | Kimberly F Lauth | Physician Assistant | 1200 Q Hammons Drive, Suite 400, Madison, WI 53717 | 2012-01-16 |
| 1699042499 | Cameron K Birch | Pharmacist | 9741 Tree Lane, Suite 201, Madison, WI 53717 | 2011-11-22 |
| 1508023102 | Katherine Jo Hartkopf | Pharmacist | 8501 Excelsior Drive, Rm. 337, Madison, WI 53717 | 2008-05-21 |
| 1366614885 | Periodontal & Implant Specialists of Madison, LLC | Dentist | 49 N Walbridge Ave., Madison, WI 53717 | 2008-03-25 |
| 1598961005 | John H Greist | Psychiatry & Neurology | Healthcare Technology Systems, Inc., 7617 Mineral Point Rd., Ste. 300, Madison, WI 53717 | 2007-06-22 |
| Find all providers in zip 53717 | ||||
| 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 |
|---|---|---|---|---|
| 1487219192 | Morgan County, Georgia Hospital Authority | Pharmacy | 1740 Lions Club Road, Madison, GA 30650 | 2019-05-08 |
| 1194227694 | Dean Retail Services, Inc. | Pharmacy | 752 N High Point Rd Ste L701, Madison, WI 53717-2236 | 2018-03-01 |
| 1578955381 | Uptown Pharmacy | Pharmacy | 1042 Gluckstadt Rd, Suite D, Madison, MS 39110-6981 | 2015-03-03 |
| 1346651296 | Roundys Supermarkets Inc | Pharmacy | 6010 Cottage Grove Rd, Madison, WI 53718-1300 | 2014-05-14 |
| 1831536648 | Keystone Pharmacy, LLC | Pharmacy | 118 Weisenberger Road, Sutie #400, Madison, MS 39110 | 2013-06-03 |
| 1376885152 | Hy Vee Inc | Pharmacy | 675 S Whitney Way, Madison, WI 53711-1034 | 2013-03-20 |
| 1982943924 | District Council of Madison Inc | Pharmacy | 2033 Fish Hatchery Rd, Madison, WI 53725-9686 | 2013-02-12 |
| 1801028030 | Hy Vee Inc | Pharmacy | 3801 E Washington Ave, Madison, WI 53704-3648 | 2009-08-21 |
| 1780875955 | Walgreen Co | Pharmacy | 129 Clifty Dr, Madison, IN 47250-1601 | 2007-08-05 |
| 1225238926 | Roundys Supermarkets Inc | Pharmacy | 3650 University Ave, Madison, WI 53705-2143 | 2007-07-20 |
| Find all providers in MADISON | ||||
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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.