SHOPKO STORES OPERATING CO LLC (NPI# 1114971926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114971926 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 061 |
| Practice Address |
501 Highway 10 Se Saint Cloud MN 56304-1250 |
| Practice Telephone | 3202535373 |
| Practice Fax Number | 3202534985 |
| Mailing Telephone | 3202535373 |
| Mailing Fax Number | 3202534985 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2016-09-14 |
| Authorized Official Name | MR. RUSSELL STEINHORST (SVP CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9204297489 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2628066 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP NUMBER | 2416926 | 01 | |
| MN | 820258300 | 05 | |
| MN | 597816500 | 05 | |
| MN | 837430000 | 05 |
| Other Name | Type Code |
|---|---|
| ShopKo Pharmacy 061 | 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 |
501 HIGHWAY 10 SE |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56304-1250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063465789 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 501 Highway 10 Se, Saint Cloud, MN 56304-1250 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316597701 | Liza Aberle | Naturopath | 22 Wilson Ave Ne # 205, Saint Cloud, MN 56304 | 2019-09-17 |
| 1902386089 | Jd Home Health Care | Clinic/Center | 4896 52nd St, St. Cloud, MN 56304 | 2018-08-17 |
| 1861490690 | Julia Anna Blonigen | Speech-Language Pathologist | 1882 Kilian Blvd, St Cloud, MN 56304 | 2005-07-14 |
| 1700111705 | St. Cloud Metropolitan Transit Commission | Non-emergency Medical Transport (VAN) | 665 Franklin Ave Ne, Saint Cloud, MN 56304-0225 | 2009-10-08 |
| 1053364976 | In Home Health LLC | Home Health | 605 Franklin Ave Ne, Saint Cloud, MN 56304-0225 | 2006-05-19 |
| 1376946806 | Charity Anne Hans | Social Worker | 511 3rd St Ne, Saint Cloud, MN 56304-0311 | 2014-09-29 |
| 1568082428 | Cloud Home Health Care Services LLC | Clinic/Center | 22 Wilson Ave Ne Ste 208, Saint Cloud, MN 56304-0440 | 2020-04-21 |
| 1326688417 | Sunshine Care Services Inc | In Home Supportive Care | 22 Wilson Ave Ne Ste 15, Saint Cloud, MN 56304-0440 | 2020-01-07 |
| 1295039204 | Rose Melinda Stark-rose | Psychologist | 22 Wilson Ave Ne # 110, Saint Cloud, MN 56304-0440 | 2011-01-05 |
| 1750448478 | Robin Stacey Colburn | Advanced Practice Midwife | 22 Wilson Ave Ne Ste 205, Saint Cloud, MN 56304-0440 | 2007-01-02 |
| Find all providers in zip 56304 | ||||
| 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 |
|---|---|---|---|---|
| 1487117792 | Costco Wholesale Corporation | Pharmacy | 3636 2nd St S, Saint Cloud, MN 56301-3732 | 2019-04-12 |
| 1235447723 | Walgreen Co | Pharmacy | 251 County Road 120 Ste 101, Saint Cloud, MN 56303-4886 | 2010-09-17 |
| 1396067468 | Coborns Inc | Pharmacy | 250 33rd Ave S, Saint Cloud, MN 56301-6131 | 2010-02-17 |
| 1750485660 | Holiday Cvs LLC | Pharmacy | 2101 13th St, Saint Cloud, FL 34769-4206 | 2006-09-12 |
| 1124122015 | Holiday Cvs LLC | Pharmacy | 3555 13th St, Saint Cloud, FL 34769-4054 | 2006-09-12 |
| 1326053638 | Walgreen Co | Pharmacy | 2505 W Division St, Saint Cloud, MN 56301-3837 | 2006-07-29 |
| 1689696361 | Grand St Paul Cvs LLC | Pharmacy | 4201 W Division St, Saint Cloud, MN 56301-6601 | 2006-07-24 |
| 1861036592 | Keshav Rx LLC | Pharmacy | 520 13th St, Saint Cloud, FL 34769-4531 | 2019-11-06 |
| 1205328663 | St.cloud Pharmacy&wellness Center | Pharmacy | 2801 13th St, Saint Cloud, FL 34769-4134 | 2018-06-01 |
| 1194897868 | Coborns Inc | Pharmacy | 2118 8th St N, Saint Cloud, MN 56303-6150 | 2006-11-15 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56304 |
Please comment or provide details below to improve the information on SHOPKO STORES OPERATING CO LLC.
| 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.