SHOPKO STORES OPERATING CO LLC (NPI# 1831143288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831143288 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 768 |
| Practice Address |
804 Us Highway 2 W Glasgow MT 59230-1600 |
| Practice Telephone | 4062288911 |
| Practice Fax Number | 4062288913 |
| Mailing Telephone | 4062288911 |
| Mailing Fax Number | 4062288913 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2012-10-04 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 1831143288 | 05 | |
| NCPDP | 2706349 | 01 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy 768 | 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 |
804 US HIGHWAY 2 W |
| City | GLASGOW |
| State | MT |
| Zip Code | 59230-1600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265078455 | Brandi Lynn Knierim | Nurse Practitioner | 24 Newton Ave, Glasgow, MT 59230 | 2019-11-21 |
| 1265895999 | Budde Family Dentistry | Clinic/Center | 120 1st Street North, Glasgow, MT 59230 | 2016-03-31 |
| 1124174115 | Joseph E Reyling | Dentist | 1009 6th Ave N, Glasgow, MT 59230 | 2007-01-25 |
| 1366719460 | Jeremy John Stringer | Nurse Anesthetist, Certified Registered | 621 3rd St S, Glasgow, MT 59230 | 2011-11-17 |
| 1932623790 | Brittne L Casterline | Chiropractor | 914 Jet Dr, Glasgow, MT 59230-1526 | 2017-08-02 |
| 1831199314 | American Lutheran Church Valley View Home | Assisted Living Facility | 1225 Perry Ln, Glasgow, MT 59230-1532 | 2005-07-27 |
| 1164849105 | Derek Beadle | Physical Therapist | 1225 Perry Ln, Glasgow, MT 59230-1532 | 2014-03-27 |
| 1295254621 | Casterline Family Chiropractic LLC | Clinic/Center | 54171 Us Highway 2, Glasgow, MT 59230-1544 | 2017-09-18 |
| 1104483668 | Kristin Wilkowski | Counselor | 1009 6th Ave N, Glasgow, MT 59230-1659 | 2019-05-21 |
| 1134644156 | Michele Hirsch | Counselor | 1009 6th Ave N, Glasgow, MT 59230-1659 | 2017-08-10 |
| Find all providers in zip 59230 | ||||
| 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 |
|---|---|---|---|---|
| 1467557132 | Western Drug of Glasgow, Inc | Pharmacy | 537 2nd Ave S, Glasgow, MT 59230-2320 | 2006-09-14 |
| 1578584504 | Family Pharmacy of Glasgow,llc | Pharmacy | 501 Happy Valley Rd, Glasgow, KY 42141-1539 | 2006-07-23 |
| 1043604812 | T J Samson Community Hospital | Pharmacy | 310 N L Rogers Wells Blvd, Glasgow, KY 42141-1300 | 2015-03-19 |
| 1417195066 | T J Samson Community Hospital | Pharmacy | 1301 N Race St, Glasgow, KY 42141-3454 | 2009-02-04 |
| 1679711741 | Glasgow Prescription Center, Inc. | Pharmacy | 615 S L Rogers Wells Blvd, Glasgow, KY 42141-1074 | 2009-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023630662 | Pharm406 Inc | Pharmacy | 1410 38th St W Ste A, Billings, MT 59102-7552 | 2020-05-16 |
| 1710521679 | Billmont Rx, LLC | Pharmacy | 1603 Grand Ave Ste 250, Billings, MT 59102-3000 | 2019-11-04 |
| 1235636689 | Daniel Patrick Doran | Pharmacy | 590 Stockett Rd, Sand Coulee, MT 59472-9745 | 2018-04-11 |
| 1477069193 | 406 Rx Pllc | Pharmacy | 117 N Main St Ste A, Three Forks, MT 59752-9013 | 2017-12-18 |
| 1508385477 | Jkw & Jira Inc. | Pharmacy | 1245 N 29th St Ste 100, Billings, MT 59101 | 2017-09-12 |
| 1326564857 | Billings Clinic Specialty Supplies and Services, LLC | Pharmacy | 1015 Broadwater Ave Ste 101, Billings, MT 59102 | 2017-08-16 |
| 1679977433 | Superior Specialty Pharmacy of Montana, LLC | Pharmacy | 20 Four Mile Dr Ste 4, Kalispell, MT 59901-2644 | 2014-10-22 |
| 1134439797 | Kc Western Drug | Pharmacy | 105 E 1st, Clyde Park, MT 59018-0000 | 2010-10-18 |
| 1669795647 | Broadus Foods, Inc | Pharmacy | 120 S Park Avenue, Broadus, MT 59317-0549 | 2010-03-05 |
| 1316135940 | Rosauers Supermarkets Inc | Pharmacy | 3255 Technology Blvd W, Bozeman, MT 59718-6854 | 2007-10-09 |
| 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.