SHOPKO STORES OPERATING CO., LLC (NPI# 1912398736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912398736 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO., LLC |
| Other Organization Name | SHOPKO PHARMACY 795 |
| Practice Address |
1026 S Challis St Salmon ID 83467-5441 |
| Practice Telephone | 2087421285 |
| Practice Fax Number | 2087421283 |
| Mailing Telephone | 2087421285 |
| Mailing Fax Number | 2087421283 |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2015-07-07 |
| Authorized Official Name | LORIE NEUMANN (DIR 3D PARTY CONTRACT & CA) |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1912398736 | 05 |
| Other Name | Type Code |
|---|---|
| Shopko Pharmacy 795 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518320241 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 202 Susan Lawrence Drive, Ida Grove, IA 51445 | 2016-03-31 |
| 1659744720 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 1203 N Main St, Andrews, TX 79714-3630 | 2015-11-11 |
| 1801272182 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 471 Wine Country Road, Prosser, WA 99350 | 2015-08-10 |
| 1992181366 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 145 Broadway Ave N, Cokato, MN 55321 | 2015-08-07 |
| 1629452776 | Shopko Stores Operating Co., LLC | Pharmacy | 429 Michigan Ave, Orofino, ID 83544-0000 | 2015-07-17 |
| 1225320419 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 106 Smith St, Bloomfield, IA 52537-2140 | 2011-05-06 |
| 1255864963 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | N2934 State Road 22, Wautoma, WI 54982-5267 | 2017-04-10 |
| 1003349101 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 100 County Road B, Shawano, WI 54166-7072 | 2017-04-05 |
| 1366828642 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 440 W Main St, Tremonton, UT 84337 | 2015-08-10 |
| 1699089995 | Shopko Stores Operating Co., LLC | Pharmacy | 1345 S Frederick Ave, Oelwein, IA 50662-3060 | 2010-07-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Colorado Business Entities | ShopKo Stores Operating Co., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Iowa Business Entities | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Washington State Corporations | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304-5263 |
| Street Address |
1026 S CHALLIS ST |
| City | SALMON |
| State | ID |
| Zip Code | 83467-5441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982074084 | Marla Hunteman | Pharmacist | 1026 S Challis St, Salmon, ID 83467-5441 | 2015-10-01 |
| 1861861643 | Catherine Cochran | Pharmacist | 1026 S Challis St, Salmon, ID 83467-5441 | 2015-09-22 |
| 1225407273 | Kami Thimons | Pharmacist | 1026 S Challis St, Salmon, ID 83467-5441 | 2015-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962010686 | Rocky Mountain Holdings, LLC | Ambulance | 17 Center Hangar Rd, Salmon, ID 83467 | 2020-07-20 |
| 1790204881 | Annah Benedict Dahle | Physical Therapist | Porgy & Petunia's Pediatric Therapy 111 E Lillian, Suite 8, Salmon, ID 83467 | 2017-09-11 |
| 1912436395 | Georgena Yanoff | Occupational Therapist | 516 Main Street #103, Salmon, ID 83467 | 2017-06-08 |
| 1134580525 | Amy Berasi | Specialist | 201 Pole Line Rd, Salmon, ID 83467 | 2016-03-11 |
| 1689098964 | Aspen Meadows Home Care LLC | In Home Supportive Care | 104 South Warpath, Salmon, ID 83467 | 2014-02-07 |
| 1366799827 | Physical Therapy Clinic,inc. | Clinic/Center | 802 Shoup Street, Salmon, ID 83467 | 2012-08-14 |
| 1689826984 | Charles John Clark | Pharmacist | 203 So. Daisy, Salmon, ID 83467 | 2008-10-17 |
| 1972767531 | Katherine I Contway | Social Worker | 204 Courthouse Dr, Salmon, ID 83467 | 2008-07-14 |
| 1215135017 | Annie J Allen | Acupuncturist | 111 Lillian Street, Suite 211, Salmon, ID 83467 | 2007-07-03 |
| 1992913479 | Steele Memorial Medical Center | Medicare Defined Swing Bed Unit | 203 S. Daisy St., Salmon, ID 83467 | 2007-05-18 |
| Find all providers in zip 83467 | ||||
| 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 |
|---|---|---|---|---|
| 1356417984 | Rigbys Pharmacy Inc | Pharmacy | 1200 Shoup St, Salmon, ID 83467 | 2006-11-27 |
| 1013540814 | Salmon Pharmacy, LLC | Pharmacy | 309 Main Street, Salmon, ID 83467 | 2020-02-20 |
| 1164804795 | Saveway Market Inc | Pharmacy | 1200 Shoup St, Salmon, ID 83467-4300 | 2015-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336709 | Family Health Services Pharmacy | Pharmacy | 218 W. Nez Perce, Jerome, ID 83338 | 2020-11-03 |
| 1841806494 | Deblaquiere Enterprises, Inc. | Pharmacy | 86 Tank Rd, Oldtown, ID 83822-5126 | 2020-09-18 |
| 1043838584 | Costco Wholesale Corporation | Pharmacy | 3403 W Chinden Blvd, Meridian, ID 83646-7151 | 2020-07-10 |
| 1265054324 | Costco Wholesale Corporation | Pharmacy | 2495 E Lincoln Rd, Idaho Falls, ID 83401-2203 | 2020-05-12 |
| 1851923544 | Rocky Mountain Pharmacy, LLC | Pharmacy | 3910 Washington Pkwy Ste A, Idaho Falls, ID 83404-7884 | 2020-02-10 |
| 1013559269 | Timberline Pharmacy | Pharmacy | 4574 N Ten Mile Rd Ste 110, Meridian, ID 83646-6930 | 2019-10-09 |
| 1508420373 | K2red LLC | Pharmacy | 447 N Idaho St, Wendell, ID 83355 | 2019-04-27 |
| 1679039135 | Hollis Family Pharmacy LLC | Pharmacy | 845 S Substation Rd, Emmett, ID 83617 | 2019-02-20 |
| 1598229809 | Clearwater Canyon Pharmacy, LLC | Pharmacy | 13020 Us-12, Orofino, ID 83544 | 2019-01-31 |
| 1861999377 | Bi-mart Corporation | Pharmacy | 11347 W State Street, Star, ID 83669 | 2018-04-11 |
| Find all providers with the same taxonomy | ||||
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.