SHOPKO INSTITUTIONAL CARE SERVICES CO LLC (NPI# 1811235781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811235781 |
| Entity Type | Organization |
| Organization Name | SHOPKO INSTITUTIONAL CARE SERVICES CO LLC |
| Other Organization Name | SHOPKO RXCARE |
| Practice Address |
3184 London Rd Eau Claire WI 54701-6834 |
| Practice Telephone | 7158323780 |
| Practice Fax Number | 7158323766 |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2013-03-05 |
| Authorized Official Name | MR. MICHAEL BETTIGA (EXECUTIVE VICE PRESIDENT AND 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 | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | NCPDP | 5133513 | 01 |
| LICENSE | 9191-42 | 01 | |
| DEA | FS3690371 | 01 | |
| WI | 1811235781 | 05 |
| Other Name | Type Code |
|---|---|
| Shopko RxCare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831515766 | Shopko Institutional Care Services Co LLC | Durable Medical Equipment & Medical Supplies | 150 N Patrick Blvd, 250, Brookfield, WI 53045-5892 | 2014-03-17 |
| 1770893968 | Shopko Institutional Care Services Co LLC | Durable Medical Equipment & Medical Supplies | 2704 Industrial Drive, Monona, WI 53713-4806 | 2010-10-21 |
| 1053621243 | Shopko Institutional Care Services Co LLC | Durable Medical Equipment & Medical Supplies | 3701 E Evergreen Dr, Ste 1000, Appleton, WI 54913-7402 | 2010-10-21 |
| Street Address |
3184 LONDON RD |
| City | EAU CLAIRE |
| State | WI |
| Zip Code | 54701-6834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912282153 | Carolyn J Johnson | Pharmacist | 3184 London Rd, Eau Claire, WI 54701 | 2011-10-19 |
| 1003287863 | Jennifer Rose Regalia | Pharmacist | 3184 London Rd, Eau Claire, WI 54701-6834 | 2015-10-19 |
| 1205237666 | Healthdirect Institutional Pharmacy Services, Inc. | Pharmacy | 3184 London Rd, Eau Claire, WI 54701-6834 | 2014-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649887563 | Molly Amanda Haferman | Pharmacist | 3184 London Road, Eau Claire, WI 54701 | 2020-09-24 |
| 1194375915 | Moments Hospice of Eau Claire LLC | Hospice Care, Community Based | 2263 East Ridge Center, Eau Claire, WI 54701 | 2019-09-13 |
| 1043778228 | Rita Marie Acosta | Emergency Medical Technician, Basic | 509 University Dr, Mcphee Atr, Eau Claire, WI 54701 | 2019-03-07 |
| 1619450954 | Michael Brown | Case Manager/Care Coordinator | 102 S Barstow St, Eau Claire, WI 54701 | 2018-09-12 |
| 1417436569 | Valerie Jayne Both | Social Worker | 1000 Starr Avenue, Eau Claire, WI 54701 | 2018-08-09 |
| 1023519055 | Rachel Delanois | Specialist/Technologist | Kinesiology --mcphee Physical Education Center 208, 509 University Drive, Eau Claire, WI 54701 | 2018-02-25 |
| 1427564863 | Matayla Springstroh | Specialist/Technologist | 509 University Drive, Eau Claire, WI 54701 | 2017-12-21 |
| 1265981062 | Molly Hart | Student in an Organized Health Care Education/Training Program | 509 University Dr., Eau Claire, WI 54701 | 2016-09-22 |
| 1982051918 | Renee Teigen-stary | Registered Nurse | 3440 Oakwood Hills Parkway, Eau Claire, WI 54701 | 2016-05-19 |
| 1699104059 | Susan Marie Keller | Speech-Language Pathologist | 3656 Mull Dr., Dove Healthcare - South, Eau Claire, WI 54701 | 2013-11-06 |
| Find all providers in zip 54701 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1548283435 | Mayo Clinic Health System-northwest Wisconsin Region, Inc. | Pharmacy | 1707 Westgate Rd Ste 1, Eau Claire, WI 54703-4964 | 2006-07-25 |
| 1750483640 | Pharmacare Ltd | Pharmacy | 2421 E Clairemont Ave, Eau Claire, WI 54701-6724 | 2006-09-02 |
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|---|---|---|---|---|
| 1922646579 | Medical Health Pharmacy LLC | Pharmacy | 8845 S Greenview Dr Ste 1, Middleton, WI 53562-2562 | 2019-12-13 |
| 1124665336 | Ltc Pharmacy Services, LLC | Pharmacy | 11739 W Bradley Rd, Milwaukee, WI 53224 | 2019-12-06 |
| 1487205944 | Hayat Pharmacy 20 LLC | Pharmacy | 805 W. Layton Ave., Suite B, Milwaukee, WI 53221 | 2019-09-26 |
| 1568015022 | T A Solberg Co Inc | Pharmacy | 232 S Courtney St Stop 3, Rhinelander, WI 54501-3308 | 2019-07-23 |
| 1932679081 | Janesville Hometown Pharmacy LLC | Pharmacy | 21 S Jackson St Ste 100, Janesville, WI 53548-3859 | 2018-12-03 |
| 1902371107 | Salvanz Enterprises Inc | Pharmacy | 2673 Lineville Rd, Green Bay, WI 54313-7124 | 2018-10-04 |
| 1962999805 | Guardian Pharmacy of Madison, LLC | Pharmacy | N85 W15882 Appleton Ave, Menomonee Falls, WI 53051-3082 | 2018-04-17 |
| 1164932091 | Mabie Pharmacy, LLC | Pharmacy | 10 Liberty St # 106, Deerfield, WI 53531-9458 | 2017-10-05 |
| 1487101754 | Evergreen Pharmacy LLC | Pharmacy | 10101 W Greenfield Ave, West Allis, WI 53214-3953 | 2016-09-05 |
| 1639548142 | Lynja Inc | Pharmacy | 3215 8th St S Ste 101, Wisconsin Rapids, WI 54494-6564 | 2015-09-15 |
| Find all providers with the same taxonomy | ||||
| City | EAU CLAIRE |
| Zip Code | 54701 |
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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.