SHOPKO STORES OPERATING CO LLC (NPI# 1841745155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841745155 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 212 |
| Practice Address |
301 E Us Highway 20 Gordon NE 69343-1650 |
| Practice Telephone | 9204294726 |
| Mailing Telephone | 9204294726 |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2016-10-14 |
| Authorized Official Name | LORIE NEUMANN (DIRECTOR OF THIRD PARTY) |
| 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 |
| Other Name | Type Code |
|---|---|
| SHOPKO PHARMACY 212 | 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 |
| 1821441205 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 6355 Main St, Bonners Ferry, ID 83805-8519 | 2016-07-20 |
| 1184073520 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 3402 Main St, Emmetsburg, IA 50536-1515 | 2016-06-07 |
| Street Address |
301 E US HIGHWAY 20 |
| City | GORDON |
| State | NE |
| Zip Code | 69343-1650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558627729 | Ronald Charles Felton | Counselor | 305 Foch Street, Gordon, NE 69343 | 2012-04-02 |
| 1306855127 | City of Gordon Office of Comptroller | Ambulance | 208 North Elm St., Gordon, NE 69343 | 2006-08-08 |
| 1922252295 | Anpo Wicahpi Charging Thunder | Family Medicine | 807 N. Ash St, Gordon, NE 69343-0000 | 2008-11-12 |
| 1285647214 | Paul C Hessler IIi | Radiology | 309 Maple Ave, Gordon, NE 69343-0174 | 2006-08-14 |
| 1982779039 | Gordon Memorial Hospital | Medicare Defined Swing Bed Unit | 300 East 8th, Gordon, NE 69343-1123 | 2006-11-22 |
| 1952885964 | Erin Sandoz | Occupational Therapist | 300 E 8th St, Gordon, NE 69343-1123 | 2018-09-17 |
| 1245684455 | Bryan Felker | Physical Therapist | 300 E 8th St, Gordon, NE 69343-1123 | 2016-04-14 |
| 1154581429 | Cassie Marie Banks | Nurse Practitioner | 300 E 8th St, Gordon, NE 69343-1123 | 2008-06-11 |
| 1720276702 | Suzanne Beth Sachs | Physician Assistant | 300 E 8th St, Gordon, NE 69343-1123 | 2007-10-04 |
| 1376740761 | Martin Emerson Lambert | Nurse Anesthetist, Certified Registered | 300 E 8th St, Gordon, NE 69343-1123 | 2007-06-28 |
| Find all providers in zip 69343 | ||||
| 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 |
|---|---|---|---|---|
| 1275637787 | Angus Lake Healthcare, LLC | Pharmacy | 240 Milledgeville Hwy # A, Gordon, GA 31031-3827 | 2006-09-13 |
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|---|---|---|---|---|
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| 1952960783 | Lincoln Pharmacy LLC | Pharmacy | 3300 A Street, Ste 100, Lincoln, NE 68510-4512 | 2019-06-06 |
| 1457819922 | Providence Medical Center | Pharmacy | 803 Providence Rd Ste 101, Wayne, NE 68787-1590 | 2019-03-04 |
| 1801374491 | Walnut Creek LLC | Pharmacy | 11020 Q Street, Omaha, NE 68137 | 2018-08-06 |
| 1992283584 | Rainwood Rx LLC | Pharmacy | 20513 Nicholas Circle, Ste 3, Elkhorn, NE 68022 | 2018-08-06 |
| 1083128250 | Innovative Pain & Spine Specialists | Pharmacy | 7121 Stephanie Ln Ste 104, Lincoln, NE 68516-5359 | 2017-11-27 |
| 1225547433 | Costco Wholesale Corportation | Pharmacy | 1620 Pine Lake Road, Lincoln, NE 68512 | 2017-09-20 |
| 1699191734 | Arborpharm, LLC | Pharmacy | 203 S 7th St, Ste B, Wymore, NE 68466 | 2014-03-13 |
| 1982020590 | B&r Stores, Inc | Pharmacy | 611 N Burlington Ave, Hastings, NE 68901-5037 | 2014-03-07 |
| 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.