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SHOPKO STORES OPERATING CO LLC NPI 1548211105


NPI Information

NPI: 1548211105
Provider Name: SHOPKO STORES OPERATING CO LLC

Doing Business As: SHOPKO PHARMACY 049

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
500 N HIGHWAY 281
ABERDEEN, SD
ZIP 57401
Phone: (605) 225-3577
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SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in Aberdeen, SD. 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 1548211105. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 049.

The provider's business location address is:

500 N HIGHWAY 281
ABERDEEN, SD
ZIP 57401-821
Phone: (605) 225-3577
Fax: (605) 225-4170

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 5/16/2006 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 Pharmacy1001906SOUTH DAKOTAYes

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
14303777OTHERNCPDP NUMBER
21111590009MEDICARE ID-TYPE UNSPECIFIED
35695760069MEDICARE NSC
48502732MEDICAIDSOUTH DAKOTA
59166122MEDICAIDSOUTH DAKOTA
6000020888SHMEDICAIDNORTH DAKOTA
78502730MEDICAIDSOUTH DAKOTA
821474MEDICAIDNORTH DAKOTA
99566280MEDICAIDSOUTH DAKOTA

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: 4/28/2024

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