SHOPKO STORES OPERATING CO LLC


Address: 506 2nd St, Jackson, MN 56143
Phone: 5078472480

SHOPKO STORES OPERATING CO LLC (NPI# 1083896716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083896716
Entity Type Organization
Organization Name SHOPKO STORES OPERATING CO LLC
Other Organization Name SHOPKO PHARMACY 777
Practice Address 506 2nd St
Jackson
MN 56143
Practice Telephone 5078472480
Practice Fax Number 5078472480
Mailing Telephone 5078472480
Mailing Fax Number 5078472480
Enumeration Date 2007-12-05
Last Update Date 2012-07-31
Authorized Official Name MR. MICHAEL BETTIGA (EXCUTIVE VICE PRESIDENT & COO)
Authorized Official Telephone 9204294297
Authorized Official Credential RPH
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 333600000X Pharmacy Suppliers
N 332B00000X Durable Medical Equipment & Medical Supplies Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers

Other Provider/Organization Names

Other Name Type Code
Shopko Pharmacy 777 Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 506 2ND ST
City JACKSON
State MN
Zip Code 56143

Providers in the same location

NPI Name Taxonomy Address Enumeration
1053456889 Jackson Drug Co Durable Medical Equipment & Medical Supplies 506 2nd St, Jackson, MN 56143-0233 2007-02-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063576965 Jackson County Central Schools Local Education Agency (LEA) Jackson County Central Schools, 1128 North Highway, Jackson, MN 56143 2006-12-22
1609952027 Susan Marie Back Psychologist 116 County Road 34 W, Jackson, MN 56143 2006-10-27
1992805204 Kevin John Dunlavey Dentist 607 2nd St, Jackson, MN 56143 2006-09-25
1285978221 Paul Anthony Roggow Dentist 604 Second Street, Jackson, MN 56143 2012-11-15
1811915648 Jackson Volunteer Ambulance Ambulance 305 Sheridan Str, Jackson, MN 56143-0242 2006-07-18
1750378758 Sister Marie Paul Lockerd Family Medicine 803 4th St, Jackson, MN 56143-1056 2005-10-04
1407065824 Desmoines Valley Bhs Clinical Nurse Specialist 803 4th St, Jackson, MN 56143-1056 2007-05-22
1942426689 Margaret Jean Hart Family Medicine 803 4th St, Jackson, MN 56143-1056 2007-04-18
1003912171 Sacred Heart Mercy Health Care Center Family Medicine 803 4th St, Jackson, MN 56143-1056 2006-09-16
1982655213 Michele Gloria Paradis Registered Nurse 803 4th St, Jackson, MN 56143-1056 2006-05-12
Find all providers in zip 56143

Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144874868 Whitney Harris Drugs, Inc. Pharmacy 1200 Eastover Dr Ste 175, Jackson, MS 39211-6317 2019-07-31
1013576826 Avita Drugs Mississippi, LLC Pharmacy 805 E River Pl Ste A, Jackson, MS 39202-3486 2019-06-06
1639677230 Walgreen Co Pharmacy 971 Lakeland Dr Ste 101, Jackson, MS 39216 2018-01-29
1952823783 Teton County Hospital District Pharmacy 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 2017-07-13
1477955037 Jackson Village Pharmacy LLC Pharmacy 27 South Cooks Bridge Rd, Suite M1, Jackson, NJ 08527 2014-09-25
1215341623 Rite Aid Pharmacy 702 Bennett Mills Road, Jackson, NJ 08527 2014-06-13
1134251812 Main Midtown Inc Pharmacy 346 E Fortification St, Jackson, MS 39202-2325 2007-03-09
1003943176 Ljc,inc Dba Stone Drug Pharmacy 830 West Broadway, Box 9000, Jackson, WY 83001 2007-02-27
1003968322 Carel Pharmacy Pharmacy 2010 W County Line Rd, Jackson, NJ 08527-2001 2007-01-17
1316095573 Gold Kimball International, Inc. Pharmacy 2080 W County Line Rd, Jackson, NJ 08527-2015 2007-01-06
Find all providers in JACKSON

Competitor

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City JACKSON
Zip Code 56143

Improve Information

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Dataset Information

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.

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