SHOPKO STORES OPERATING CO., LLC (NPI# 1801272182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801272182 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO., LLC |
| Other Organization Name | SHOPKO PHARMACY #2556 |
| Practice Address |
471 Wine Country Road Prosser WA 99350 |
| Practice Telephone | 9204294726 |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-12-23 |
| Authorized Official Name | LORIE NEUMANN (DIR 3D PARTY CONTRACT & CA) |
| Authorized Official Telephone | 9204294726 |
| 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 |
|---|---|---|---|
| WA | 2048036 | 05 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy #2556 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518320241 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 202 Susan Lawrence Drive, Ida Grove, IA 51445 | 2016-03-31 |
| 1659744720 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 1203 N Main St, Andrews, TX 79714-3630 | 2015-11-11 |
| 1992181366 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 145 Broadway Ave N, Cokato, MN 55321 | 2015-08-07 |
| 1629452776 | Shopko Stores Operating Co., LLC | Pharmacy | 429 Michigan Ave, Orofino, ID 83544-0000 | 2015-07-17 |
| 1912398736 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 1026 S Challis St, Salmon, ID 83467-5441 | 2015-02-16 |
| 1225320419 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 106 Smith St, Bloomfield, IA 52537-2140 | 2011-05-06 |
| 1255864963 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | N2934 State Road 22, Wautoma, WI 54982-5267 | 2017-04-10 |
| 1003349101 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 100 County Road B, Shawano, WI 54166-7072 | 2017-04-05 |
| 1366828642 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 440 W Main St, Tremonton, UT 84337 | 2015-08-10 |
| 1699089995 | Shopko Stores Operating Co., LLC | Pharmacy | 1345 S Frederick Ave, Oelwein, IA 50662-3060 | 2010-07-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Colorado Business Entities | ShopKo Stores Operating Co., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Iowa Business Entities | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Washington State Corporations | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304-5263 |
| Street Address |
471 WINE COUNTRY ROAD |
| City | PROSSER |
| State | WA |
| Zip Code | 99350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306469580 | Benton Southgate Pharmacy Inc | Pharmacy | 471 Wine Country Road, Prosser, WA 99350 | 2020-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083091466 | Sarah Min | Pediatrics | Prosser Clinic-prosser Memorial Health, 336 Chardonnay Ave Suite A, Prosser, WA 99350 | 2015-05-05 |
| 1174939805 | Kiranmayi Korimerla | Family Medicine | 336 Chardinnay Ave #a, Kadlec Clinic Prosser Primary Care, Prosser, WA 99350 | 2014-07-02 |
| 1427478965 | Dzmitry Zhmurouski | Internal Medicine | 336 Chardonnay Ave., Suite A, Prosser, WA 99350 | 2014-04-23 |
| 1972920080 | David Carl | Pediatrics | Benton City Clinic-prosser Memorial Health, 701 Dale Ave Suite A, Benton City, WA 99350 | 2014-03-26 |
| 1619310554 | Weslee Chew | Surgery | Prosser Specialty Clinic-prosser Memorial Health, 820 Memorial Street Suite 3, Prosser, WA 99350 | 2013-04-10 |
| 1871844894 | Teresa Renee Charvet | Physician Assistant | 336 Chardonnay Ave Bldg 3, Prosser, WA 99350 | 2012-10-01 |
| 1376894048 | Walla Walla General Hospital | Clinic/Center | 336 Chardonnay Ave Ste A, Prosser, WA 99350 | 2012-09-21 |
| 1902162274 | Nicole Deanne Denny | Speech-Language Pathologist | 326 Chardonnay Blvd, Prosser Physical Therapy and Rehab, Prosser, WA 99350 | 2012-04-11 |
| 1386934461 | Brian G Sollers | Obstetrics & Gynecology | 336 Chardonnay Ave, Bldg 3, Prosser, WA 99350 | 2011-04-11 |
| 1073811998 | Stefanie Jean Wisse | Dietitian, Registered | 820 Memorial St., Suite 1, Prosser, WA 99350 | 2011-03-01 |
| Find all providers in zip 99350 | ||||
| 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 |
|---|---|---|---|---|
| 1700417854 | Prosser Southgate Pharmacy Inc | Pharmacy | 207 Canyon Drive, Prosser, WA 99350-1009 | 2020-01-28 |
| 1073170296 | Shiva LLC | Pharmacy | 354 Chardonnay Ave Ste 5, Prosser, WA 99350-9545 | 2019-05-22 |
| 1306469580 | Benton Southgate Pharmacy Inc | Pharmacy | 471 Wine Country Road, Prosser, WA 99350 | 2020-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700493533 | Doctors Pharmacy, LLC | Pharmacy | 65 Columbia Point Dr, Richland, WA 99352-4375 | 2020-09-25 |
| 1871105999 | Whidbey Island Public Hospital District | Pharmacy | 7 Ne Birch St, Coupeville, WA 98239-3132 | 2020-08-19 |
| 1710504550 | Kayshuv Enterprises | Pharmacy | 7505 Sandifur Pkwy, Suite 102, Pasco, WA 99301 | 2020-06-27 |
| 1811511454 | Kaiser Foundation Health Plan of Washington | Pharmacy | 189 Telegraph Rd, Bellingham, WA 98226-8079 | 2020-05-29 |
| 1548883630 | Capsule Seattle LLC | Pharmacy | 2033 6th Ave Ste 120, Seattle, WA 98121-2526 | 2020-05-22 |
| 1063048197 | Peninsula Pharmacies Inc Long Beach Pharmacy Annex | Pharmacy | 110 Oregon Ave S, Long Beach, WA 98631 | 2020-03-20 |
| 1174155345 | Kaiser Foundation Health Plan of Washington | Pharmacy | 2335 172nd Street Ne, Marysville, WA 98271 | 2020-02-06 |
| 1245861996 | Salish Integrative Medicine, Inc | Pharmacy | 3700 Pacific Hwy E Ste 100b, Fife, WA 98424-1160 | 2020-01-31 |
| 1700423639 | Venkateswara LLC | Pharmacy | 515 Minor Ave Ste 120, Seattle, WA 98104-2138 | 2019-12-10 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 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.