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SHOPKO STORES OPERATING CO LLC NPI 1881647840


NPI Information

NPI: 1881647840
Provider Name: SHOPKO STORES OPERATING CO LLC

Doing Business As: SHOPKO PHARMACY 749

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
301 1ST AVE S
SAINT JAMES, MN
ZIP 56081
Phone: (507) 375-8115
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SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in Saint James, MN. 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 1881647840. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 749.

The provider's business location address is:

301 1ST AVE S
SAINT JAMES, MN
ZIP 56081-723
Phone: (507) 375-8115
Fax: (507) 375-8357

The provider's authorized official is Michael Bettiga .
The authorized official title is Executive Vice President & Coo and has the following contact phone number (920) 429-4297.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 9/24/2012.


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
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1728113000MEDICAIDMINNESOTA
22424276OTHERNCPDP
30459230089MEDICARE ID-TYPE UNSPECIFIED
4891450800MEDICAIDMINNESOTA
55695760199MEDICARE NSC

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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