SHOPKO STORES OPERATING CO LLC (NPI# 1669401899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669401899 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 634 |
| Practice Address |
1020 W Chestnut St Hoopeston IL 60942-1967 |
| Mailing Address |
Po Box 1450 Minneapolis MN 55485-5891 |
| Practice Telephone | 2172834456 |
| Practice Fax Number | 2172834634 |
| Mailing Telephone | 2172834456 |
| Mailing Fax Number | 2172834634 |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2012-08-30 |
| 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 |
|---|---|---|---|
| MEDICARE ID - TYPE UNSPECIFIED | 0459230130 | 01 | |
| NCPDP | 1477341 | 01 | |
| IL | 203606157004 | 05 | |
| IL | 470626426119 | 05 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy 634 | 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 |
1020 W CHESTNUT ST |
| City | HOOPESTON |
| State | IL |
| Zip Code | 60942-1967 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114348281 | Arrow Ambulance, LLC | Ambulance | 411 W. Main Street, Hoopeston, IL 60942 | 2013-12-17 |
| 1205156940 | Aslam Ahmed Mohammed | Emergency Medicine | 801 E. Orange St, Hoopeston, IL 60942 | 2010-06-04 |
| 1447685524 | Smart Chiropractic, LLC | Clinic/Center | 309 E Main St, Hoopeston, IL 60942 | 2013-09-09 |
| 1881636603 | Hoopeston Retirement Village Foundation | Skilled Nursing Facility | 423 N Dixie Hwy, Hoopeston, IL 60942-1021 | 2006-06-13 |
| 1306488101 | Erika Dawn Weber | Occupational Therapist | 423 N Dixie Hwy, Hoopeston, IL 60942-1021 | 2019-10-13 |
| 1740534163 | Hoopeston Retirement Village Foundation, Inc | Durable Medical Equipment & Medical Supplies | 423 N Dixie Hwy, Hoopeston, IL 60942-1033 | 2012-11-07 |
| 1023129764 | Christopher P. Scott | Chiropractor | 913 W Main St, Hoopeston, IL 60942-1042 | 2006-08-31 |
| 1073149092 | Terra Marie Kinney | Physician Assistant | 618 E Honeywell Ave, Hoopeston, IL 60942-1411 | 2020-03-21 |
| 1710153077 | Community Health Partnership of Il | Clinic/Center | 622 S 8th Ave, Hoopeston, IL 60942-1781 | 2008-05-06 |
| 1891708137 | Stuart L. Rotramel | Registered Nurse | 701 East Orange St, Hoopeston Community Hospital, Hoopeston, IL 60942-1801 | 2006-08-15 |
| Find all providers in zip 60942 | ||||
| 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 |
|---|---|---|---|---|
| 1487757159 | Highland Park Cvs LLC | Pharmacy | 805 S Dixie Hwy, Hoopeston, IL 60942-1939 | 2006-09-07 |
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| 1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
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| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
| 1982212635 | Grand Pharmacy LLC | Pharmacy | 229 W Grand Ave Ste F, Bensenville, IL 60106-3365 | 2020-07-20 |
| 1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
| 1831716745 | The Project of The Quad Cities | Pharmacy | 1701 River Dr Ste 106, Moline, IL 61265-1384 | 2020-06-26 |
| 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.