SHOPKO STORES OPERATING CO LLC NPI 1174941231

NPI Information

  • NPI: 1174941231
  • Provider Name: SHOPKO STORES OPERATING CO LLC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: SHOPKO PHARMACY 716
  • Address: 1520 W 9TH ST
    MOUNT CARMEL, IL
    ZIP 62863
  • Phone: (618) 262-2475

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NPI Details

SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in Mount Carmel, IL. 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 1174941231. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 716.

The provider's business location address is:

1520 W 9TH ST
MOUNT CARMEL, IL
ZIP 62863-909
Phone: (618) 262-2475

The provider's authorized official is Lorie Neumann .
The authorized official title is Vp Retail Health Services and has the following contact phone number (920) 429-4726.

The enumeration date for this NPI number is 4/4/2014 and was last updated on 9/4/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15695760291MEDICARE NSCILLINOIS
2P00836438OTHERILLINOISRAIL ROAD MEDICARE

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: 11/21/2025

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