SHOPKO STORES OPERATING CO LLC (NPI# 1184676165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184676165 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 723 |
| Practice Address |
2300 State Route 534 Newton Falls OH 44444-8747 |
| Practice Telephone | 3308721276 |
| Practice Fax Number | 3308721285 |
| Mailing Telephone | 3308721276 |
| Mailing Fax Number | 3308721285 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2013-03-13 |
| 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 |
|---|---|---|---|
| OH | 0991502 | 05 | |
| NCPDP NUMBER | 3660239 | 01 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy 723 | 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 |
2300 STATE ROUTE 534 |
| City | NEWTON FALLS |
| State | OH |
| Zip Code | 44444-8747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093015125 | Philip Michael Lefoer | Pharmacist | 2300 State Route 534, Newton Falls, OH 44444 | 2010-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093169435 | Tracy Lee Lewis | Speech-Language Pathologist | 905 Milton Blvd., Newton Falls Schools, Newton Falls, OH 44444 | 2016-04-22 |
| 1912305335 | Judith Ann Ciarrochi | Psychologist | 907 Milton Boulevard, Newton Falls Exempted Village Schools, Newton Falls, OH 44444 | 2014-12-17 |
| 1629070552 | Charles L. Demario | Family Medicine | 340 Ridge Road, Suite 1, Newton Falls, OH 44444 | 2005-08-11 |
| 1245654631 | Monica Rai Wolford | Physical Therapy Assistant | 5158 Grand Blvd, Newton Falls, OH 44444-1009 | 2014-02-06 |
| 1023232758 | Denton Duane Cottrill | Licensed Practical Nurse | 16 Grant St, Newton Falls, OH 44444-1116 | 2007-04-12 |
| 1134512643 | Sherri Lohry | Licensed Practical Nurse | 4381 Ticknor Ave, Newton Falls, OH 44444-1141 | 2015-03-08 |
| 1619373917 | Tina O'neill | Home Health Aide | 458 Circle Dr, Newton Falls, OH 44444-1222 | 2014-11-13 |
| 1306234018 | Liane King | Home Health Aide | 238 W Jay St, Newton Falls, OH 44444-1224 | 2015-01-03 |
| 1245425875 | Newton Falls Pharmacy Inc | Pharmacy | 37 Ridge Rd, Newton Falls, OH 44444-1232 | 2007-09-06 |
| 1790220929 | Laura Lytle | Pharmacist | 37 Ridge Rd, Newton Falls, OH 44444-1232 | 2016-12-26 |
| Find all providers in zip 44444 | ||||
| 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 |
|---|---|---|---|---|
| 1245425875 | Newton Falls Pharmacy Inc | Pharmacy | 37 Ridge Rd, Newton Falls, OH 44444-1232 | 2007-09-06 |
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| 1689200461 | Cross Point Pharmacy | Pharmacy | 800 Cross Pointe Rd Ste P, Gahanna, OH 43230-6690 | 2020-03-12 |
| 1245870864 | Bravo Rx Pharmacy | Pharmacy | 4125 W Broad St # B, Columbus, OH 43228-1600 | 2020-01-11 |
| 1235777350 | Tan Thai Inc | Pharmacy | 4300 Clime Rd Ste 111, Columbus, OH 43228-6491 | 2019-12-19 |
| 1144868597 | Blanchard Valley Regional Health Center | Pharmacy | 930 Sheriden Dr Ste C, Carey, OH 43316-1502 | 2019-12-17 |
| Find all providers with the same taxonomy | ||||
| City | NEWTON FALLS |
| Zip Code | 44444 |
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.