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SHOPKO STORES OPERATING CO LLC NPI 1992756084


NPI Information

NPI: 1992756084
Provider Name: SHOPKO STORES OPERATING CO LLC

Doing Business As: SHOPKO PHARMACY 053

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
510 E PHILIP AVE
NORTH PLATTE, NE
ZIP 69101
Phone: (308) 534-7353
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SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in North Platte, NE. The provider is 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. SHOPKO STORES OPERATING CO LLC NPI is 1992756084. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 053.

The provider's business location address is:

510 E PHILIP AVE
NORTH PLATTE, NE
ZIP 69101-538
Phone: (308) 534-7353
Fax: (308) 534-2625

The provider's authorized official is Michael J Bettiga .
The authorized official title is Sr. Vice President Health Services and has the following contact phone number (920) 429-4297.

The enumeration date for this NPI number is 5/13/2006 and was last updated on 10/28/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2332H00000XEyewear SupplierNo
33336C0003XPharmacyCommunity/Retail Pharmacy2682Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10154160089MEDICARE ID-TYPE UNSPECIFIED
22812748OTHERNCPDP NUMBER
35695760062MEDICARE NSC
441098505415MEDICAIDNEBRASKA
510025414300MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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