SHOPKO INSTITUTIONAL CARE SERVICES CO LLC (NPI# 1831515766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831515766 |
| Entity Type | Organization |
| Organization Name | SHOPKO INSTITUTIONAL CARE SERVICES CO LLC |
| Other Organization Name | SHOPKO RXCARE 404 |
| Practice Address |
150 N Patrick Blvd 250 Brookfield WI 53045-5892 |
| Practice Telephone | 9204292211 |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2014-03-17 |
| Authorized Official Name | 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 |
9248-42 | WI | Suppliers |
| Other Name | Type Code |
|---|---|
| SHOPKO RXCARE 404 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770893968 | Shopko Institutional Care Services Co LLC | Durable Medical Equipment & Medical Supplies | 2704 Industrial Drive, Monona, WI 53713-4806 | 2010-10-21 |
| 1811235781 | Shopko Institutional Care Services Co LLC | Durable Medical Equipment & Medical Supplies | 3184 London Rd, Eau Claire, WI 54701-6834 | 2013-01-28 |
| 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 |
150 N PATRICK BLVD 250 |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53045-5892 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528469988 | Healthdirect Institutional Pharmacy Services, Inc. | Pharmacy | 150 N Patrick Blvd, Suite 250, Brookfield, WI 53045-5892 | 2014-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801436159 | Jeannie Spoon | Behavioral Analyst | 200 N. Patrick Blvd. Ste 250, Brookfield, WI 53045 | 2020-01-14 |
| 1629635313 | Hallie Mackenzie Ritchay | Speech-Language Pathologist | Greenfield Rehabilitation Agency 19395 W Capitol Dr, Ste 200, Brookfield, WI 53045 | 2019-05-29 |
| 1427535038 | Kimberly Ann Beres | Registered Nurse | 2253 Norhardt Dr, Brookfield, WI 53045 | 2018-07-26 |
| 1265927768 | Brady Frederick Bachmann | Physical Therapist | 275 Regency Ct., Suite 200, Brookfield, WI 53045 | 2018-06-27 |
| 1841792603 | Wisconsin Renal Care Group, L.L.C. | Clinic/Center | 17500 W Capitol Drive, Brookfield, WI 53045 | 2018-03-07 |
| 1750828299 | Nanette Marie Kloth | Nurse Practitioner | 18110 W Bluemond Rd, Brookfield, WI 53045 | 2017-01-23 |
| 1144772013 | Saida Reifenrath | Acupuncturist | 240 Regency Court, Suite 102, Brookfield, WI 53045 | 2016-10-26 |
| 1437545951 | Kylee Stevenson | Chiropractor | 19555 W Bluemound Rd Ste 6, Brookfield, WI 53045 | 2015-04-10 |
| 1548659725 | Patricia Ann Kender | Nurse Practitioner | 17495 W. Capitol Dr., Brookfield, WI 53045 | 2015-01-12 |
| 1568882793 | Kassandra E Holzem | Dermatology | 195 Discovery Dr, Brookfield, WI 53045 | 2014-04-28 |
| Find all providers in zip 53045 | ||||
| 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 |
|---|---|---|---|---|
| 1902990179 | Wheaton Franciscan Pharmacy | Pharmacy | 13950 W Capitol Dr, Brookfield, WI 53005-2441 | 2006-10-03 |
| 1639126139 | Gardner Pharmacy Services Inc | Pharmacy | 712 S Main St, Brookfield, MO 64628-2307 | 2006-05-28 |
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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 | BROOKFIELD |
| Zip Code | 53045 |
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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.