SHOPKO STORES OPERATING CO LLC (NPI# 1053590588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053590588 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 523 |
| Practice Address |
525 E Highway 20 Valentine NE 69201-2115 |
| Practice Telephone | 4023763531 |
| Practice Fax Number | 4023763560 |
| Mailing Telephone | 4023763531 |
| Mailing Fax Number | 4023763560 |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2014-05-01 |
| Authorized Official Name | MR. MICHAEL BETTIGA (EXECUTIVE VICE PRESIDENT & COO) |
| Authorized Official Telephone | 9204294297 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 10026193100 | 05 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy 523 | 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 |
525 E HIGHWAY 20 |
| City | VALENTINE |
| State | NE |
| Zip Code | 69201-2115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790148856 | Brett Spotted Elk | Non-emergency Medical Transport (VAN) | 212 Brave St, Valentine, NE 69201 | 2016-04-05 |
| 1013370360 | Kimberley Hernandez | Non-emergency Medical Transport (VAN) | 3581 Sicangu Village Dr #19, Valentine, NE 69201 | 2016-04-04 |
| 1528220886 | James S Svoboda | Speech-Language Pathologist | 601 W 4th, Pob 180, Valentine, NE 69201 | 2008-06-27 |
| 1497811830 | Cherry County Drug | Pharmacy | 316 N Main, Valentine, NE 69201 | 2006-12-29 |
| 1982771242 | David John Higgins | Dentist | 308 North Main Street, Valentine, NE 69201 | 2006-11-29 |
| 1518365493 | Claire Elizabeth Carr | Physician Assistant | 502 N Cherry St, Valentine, NE 69201 | 2014-12-09 |
| 1114027067 | Janice I Tetherow | Counselor | 442 N Cherry St, Valentine, NE 69201-1516 | 2006-09-22 |
| 1184734592 | Michele Nicole Mulligan-witt | Family Medicine | 502 N Cherry St, Valentine, NE 69201-1518 | 2006-08-30 |
| 1669936423 | Sarah Fitzpatrick | Physician Assistant | 502 N Cherry St, Valentine, NE 69201-1518 | 2019-01-25 |
| 1164532594 | Michael Paulus Crisman | Physician Assistant | 502 N Cherry St, Valentine, NE 69201-1518 | 2006-08-30 |
| Find all providers in zip 69201 | ||||
| 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 |
|---|---|---|---|---|
| 1003963760 | Valentine Clinic Pharmacy | Pharmacy | 272 N Main St, Valentine, NE 69201-1818 | 2007-01-04 |
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| 1952960783 | Lincoln Pharmacy LLC | Pharmacy | 3300 A Street, Ste 100, Lincoln, NE 68510-4512 | 2019-06-06 |
| 1457819922 | Providence Medical Center | Pharmacy | 803 Providence Rd Ste 101, Wayne, NE 68787-1590 | 2019-03-04 |
| 1801374491 | Walnut Creek LLC | Pharmacy | 11020 Q Street, Omaha, NE 68137 | 2018-08-06 |
| 1992283584 | Rainwood Rx LLC | Pharmacy | 20513 Nicholas Circle, Ste 3, Elkhorn, NE 68022 | 2018-08-06 |
| 1083128250 | Innovative Pain & Spine Specialists | Pharmacy | 7121 Stephanie Ln Ste 104, Lincoln, NE 68516-5359 | 2017-11-27 |
| 1225547433 | Costco Wholesale Corportation | Pharmacy | 1620 Pine Lake Road, Lincoln, NE 68512 | 2017-09-20 |
| 1699191734 | Arborpharm, LLC | Pharmacy | 203 S 7th St, Ste B, Wymore, NE 68466 | 2014-03-13 |
| 1982020590 | B&r Stores, Inc | Pharmacy | 611 N Burlington Ave, Hastings, NE 68901-5037 | 2014-03-07 |
| Find all providers with the same taxonomy | ||||
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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.