SHOPKO STORES OPERATING CO LLC (NPI# 1902971831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902971831 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 655 |
| Practice Address |
1625 E Main St Montpelier OH 43543 |
| Practice Telephone | 4194853570 |
| Practice Fax Number | 4194853590 |
| Mailing Telephone | 4194853570 |
| Mailing Fax Number | 4194853590 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2012-10-25 |
| 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 |
|---|---|---|---|
| NCPDP NUMBER | 3675507 | 01 | |
| OH | 2719026 | 05 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy 655 | 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 |
1625 E MAIN ST |
| City | MONTPELIER |
| State | OH |
| Zip Code | 43543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093955460 | Montpelier Exempted Village Sd | Local Education Agency (LEA) | 1015 E Brown Rd, Montpelier, OH 43543 | 2009-02-25 |
| 1013005255 | Williams County Office of Auditor | Public Health or Welfare | 310 Lincoln Avenue, Montpelier, OH 43543 | 2006-10-11 |
| 1538559455 | Samaritan Emergency Physicians LLP | Emergency Medicine | 909 East Snyder Avenue, Montpelier, OH 43543 | 2015-01-30 |
| 1982676128 | Roger Lee Saneholtz | Optometrist | 306 W Main St, Montpelier, OH 43543 | 2006-02-02 |
| 1174562466 | James Chester Wallace | Chiropractor | 110 N Jonesville St, Montpelier, OH 43543-1006 | 2006-06-05 |
| 1124259692 | Joseph P Boyle Sr. | Pharmacist | 221 W Main St, Montpelier, OH 43543-1015 | 2009-08-02 |
| 1831287036 | Steve William Rings | Pharmacist | 221 W Main St, Montpelier, OH 43543-1015 | 2006-10-11 |
| 1093803140 | Scott Stephen Brandt | Pharmacist | 221 W Main St, Montpelier, OH 43543-1015 | 2006-10-11 |
| 1033130166 | Rings Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 221 W Main St, Montpelier, OH 43543-1015 | 2006-07-22 |
| 1568573350 | Tri-state Vision Center, Inc. | Optometrist | 306 W Main St, Montpelier, OH 43543-1018 | 2006-08-31 |
| Find all providers in zip 43543 | ||||
| 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 |
|---|---|---|---|---|
| 1750525754 | Broulims Supermarkets, LLC | Pharmacy | 130 S 4th St, Montpelier, ID 83254-1538 | 2009-04-22 |
| 1083684906 | Olson's Modern Drug Co. | Pharmacy | 762 Washington St, Montpelier, ID 83254-1422 | 2006-01-24 |
| 1235656018 | Kph Healthcare Services, Inc. | Pharmacy | 69 Main St, Montpelier, VT 05602-2931 | 2017-08-23 |
| 1538251129 | Maxi Green Inc | Pharmacy | 60 Main Street, Montpelier, VT 05602 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295335024 | Hux Enterprises | Pharmacy | 641 Hill Rd N Ste C, Pickerington, OH 43147-9346 | 2020-10-30 |
| 1891302626 | Uc Healthcare System | Pharmacy | 222 Piedmont Ave Ste 2000, Cincinnati, OH 45219-4231 | 2020-09-25 |
| 1619580966 | Lcrg Bros LLC | Pharmacy | 7584 E Main St, Reynoldsburg, OH 43068-1208 | 2020-08-26 |
| 1528686763 | Lorain Chemists Inc | Pharmacy | 3815 Lorain Ave, Cleveland, OH 44113-3710 | 2020-07-13 |
| 1699397646 | D & G Partners LLC | Pharmacy | 7623 E Main St, Reynoldsburg, OH 43068-1209 | 2020-05-13 |
| 1992325567 | The Kroger Co | Pharmacy | 3255 Eden Ave, Suite 336, Cincinnati, OH 45229 | 2020-04-23 |
| 1689200461 | Cross Point Pharmacy | Pharmacy | 800 Cross Pointe Rd Ste P, Gahanna, OH 43230-6690 | 2020-03-12 |
| 1245870864 | Bravo Rx Pharmacy | Pharmacy | 4125 W Broad St # B, Columbus, OH 43228-1600 | 2020-01-11 |
| 1235777350 | Tan Thai Inc | Pharmacy | 4300 Clime Rd Ste 111, Columbus, OH 43228-6491 | 2019-12-19 |
| 1144868597 | Blanchard Valley Regional Health Center | Pharmacy | 930 Sheriden Dr Ste C, Carey, OH 43316-1502 | 2019-12-17 |
| Find all providers with the same taxonomy | ||||
| City | MONTPELIER |
| Zip Code | 43543 |
Please comment or provide details below to improve the information on SHOPKO STORES OPERATING CO LLC.
| 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.