SHOPKO STORES OPERATING CO LLC (NPI# 1851330740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851330740 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 755 |
| Practice Address |
1701 16th St Wheatland WY 82201-2243 |
| Practice Telephone | 3073222030 |
| Practice Fax Number | 3073222082 |
| Mailing Telephone | 3073222030 |
| Mailing Fax Number | 3073222082 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2012-10-15 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 111696700 | 05 | |
| WY | 123289401 | 05 | |
| WY | 123289400 | 05 | |
| NCPDP | 5203168 | 01 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy 755 | 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 |
1701 16TH ST |
| City | WHEATLAND |
| State | WY |
| Zip Code | 82201-2243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700338936 | Jamie Lee Hale | Pharmacist | 1701 16th St, Wheatland, WY 82201-2243 | 2016-11-04 |
| 1154518827 | Lyndsi Lee Davis | Pharmacist | 1701 16th St, Pharmacy, Wheatland, WY 82201-2243 | 2007-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790214104 | Kayla Dockter | Speech-Language Pathologist | 371 S. Kansas, Guernsey, WY 82201 | 2017-06-08 |
| 1932484763 | Diana Blanche Lengkeek | Counselor | 917 Gilchrist Street, Suite 2, Wheatland, WY 82201 | 2011-10-12 |
| 1750669321 | Kari Magnuson | Counselor | 602 9th St, Wheatland, WY 82201 | 2011-07-29 |
| 1871619726 | Barbara Larson | Counselor | 1954 W Mariposa Prkwy, Wheatland, WY 82201 | 2007-03-22 |
| 1699812776 | Mark Joseph Anderson | Dentist | 1950 South St, Wheatland, WY 82201 | 2007-01-30 |
| 1548342298 | Jo Lynn Hawthorne | Obstetrics & Gynecology | 2350 22nd Street, Wheatland, WY 82201 | 2006-10-20 |
| 1770692857 | Services for Seniors Program, Inc | Public Health or Welfare | 1605 16th Street, Wheatland, WY 82201 | 2006-08-30 |
| 1376037077 | Brittany Jenkins-stofflet | Community Health Worker | 1954 W Mariposa Pkwy, Wheatland, WY 82201 | 2018-06-18 |
| 1821324567 | Platte County Hospital District Board | Skilled Nursing Facility | 204 15th St, Wheatland, WY 82201 | 2009-10-31 |
| 1255407706 | David Beauprez | Chiropractor | 1557 Oak St, Wheatland, WY 82201-2237 | 2006-11-27 |
| Find all providers in zip 82201 | ||||
| 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] |
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| 1689136038 | Cvs Pharmacy Inc | Pharmacy | 1708 Dell Range Blvd, Cheyenne, WY 82009-4945 | 2019-04-04 |
| 1902365240 | Worland Pharmacy Inc. | Pharmacy | 1095 Circle Rd, Worland, WY 82401 | 2019-03-17 |
| 1285140376 | Bear Lake Community Health Center | Pharmacy | 75 Yellow Creek Rd Ste 102, Evanston, WY 82930-5205 | 2017-12-27 |
| 1922514017 | Bear Lake Community Health Center | Pharmacy | 2620 Commercial Way Ste 121, Rock Springs, WY 82901-4746 | 2017-12-27 |
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1487047122 | Glenrock Hsopital District | Pharmacy | 925 West Birch, Glenrock, WY 82637-0786 | 2015-03-05 |
| 1619386901 | Kmart Pharmacy | Pharmacy | 4000 East 2nd, Casper, WY 82609 | 2014-08-12 |
| 1235402132 | Afton Family Pharmacy | Pharmacy | 141 N Washington St, Afton, WY 83110 | 2012-02-23 |
| 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.