SHOPKO STORES OPERATING CO LLC


Address: 202 Sw Kent, Greenfield, IA 50849-0254
Phone: 6417432201

SHOPKO STORES OPERATING CO LLC (NPI# 1720112816) 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) 1720112816
Entity Type Organization
Organization Name SHOPKO STORES OPERATING CO LLC
Other Organization Name SHOPKO PHARMACY 687
Practice Address 202 Sw Kent
Greenfield
IA 50849-0254
Practice Telephone 6417432201
Practice Fax Number 6417432203
Mailing Telephone 6417432201
Mailing Fax Number 6417432203
Enumeration Date 2007-03-14
Last Update Date 2013-04-18
Authorized Official Name MR. MICHAEL BETTIGA (EXECUTUIVE 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 332B00000X Durable Medical Equipment & Medical Supplies Suppliers
N 333600000X Pharmacy Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
IA 0766279 05

Other Provider/Organization Names

Other Name Type Code
Shopko Pharmacy 687 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 202 SW KENT
City GREENFIELD
State IA
Zip Code 50849-0254

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659317865 Robert A Weiland Optometrist 107 Ne 2nd Street, Greenfield, IA 50849 2006-06-22
1023386547 Zion Recovery Services, Inc. Clinic/Center 132 Southeast Court Dr., Greenfield, IA 50849-0255 2011-12-12
1508987819 Staci Jean Jones Dietitian, Registered 304 Nw 2nd St, Greenfield, IA 50849-1027 2007-04-03
1417024365 Joshua Amyas Rardin Chiropractor 112 Ne Hayes St, Greenfield, IA 50849-1048 2006-11-29
1346645546 Rardin Chiropractic Pllc Chiropractor 112 Ne Hayes St, Greenfield, IA 50849-1048 2014-10-30
1124152814 Lisa Anne Rardin Chiropractor 112 Ne Hayes St, Greenfield, IA 50849-1048 2007-03-15
1053467159 Support Services of South Central Iowa Community/Behavioral Health 306 Public Sq, Greenfield, IA 50849-1257 2007-01-25
1902333503 Greater Regional Medical Center Clinic/Center 246 Public Sq, Greenfield, IA 50849-1258 2017-05-15
1588757991 Verlin Hubert Hockett Dentist 242 Public Sq, Box 240, Greenfield, IA 50849-1258 2006-09-30
1811551393 James D. Elliott Dds Pllc Dentist 242 Public Sq, Greenfield, IA 50849-1258 2019-04-30
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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
1093280513 Hayat Pharmacy 6 LLC Pharmacy 5233 S 27th St Ste 101, Greenfield, WI 53221-3764 2018-10-11
1760838528 Med Rx Pharmacy PC Pharmacy 108 S Front St, Greenfield, TN 38230-1925 2016-05-11
1265718977 Walgreen Co Pharmacy 329 Conway St Ste 3, Greenfield, MA 01301 2011-10-26
1568750545 Roundys Supermarkets Inc Pharmacy 4279 S 76th St, Greenfield, WI 53220-2804 2011-07-12
1770682130 Cvs Pharmacy Inc Pharmacy 137 Federal St, Greenfield, MA 01301-2544 2006-09-22
1295838928 Hook Superx LLC Pharmacy 1233 N State St, Greenfield, IN 46140-1056 2006-09-07
1184631061 Walgreen Co Pharmacy 4296 S 76th St, Greenfield, WI 53220-2805 2006-08-02
1750788915 Advanced Pain Management Sc Pharmacy 4131 W Loomis Rd, Suite 250, Greenfield, WI 53221-2057 2014-12-03
1316353626 Hayat Pharmacy 6 LLC Pharmacy 4931 S 27th St Ste 400, Greenfield, WI 53221-2653 2014-07-08
1902189202 Walgreens Pharmacy Pharmacy 1195 N State St, Greenfield, IN 46140-1207 2011-09-22
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Competitor

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City GREENFIELD
Zip Code 50849

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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