Shopko Stores Operating Co LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SHOPKO STORES OPERATING CO LLC

Doing business as

Shopko Pharmacy 201

Practice address

3402 Main St
Emmetsburg, IA 50536-1515

Phone

(920) 429-4726

NPI assigned

Jun 7, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lorie Neumann

Title

Director of Third Party

Phone

(920) 429-4726

Specialties & licenses 3

Addresses

Other names 1

• SHOPKO PHARMACY 201 Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1184073520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 MAIN ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505361515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 MAIN ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505361515",
            "telephone_number": "920-429-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "NEUMANN",
        "authorized_official_first_name": "LORIE",
        "authorized_official_title_or_position": "DIRECTOR OF THIRD PARTY",
        "authorized_official_telephone_number": "920-429-4726"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOPKO PHARMACY 201",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Minn Richard, ARNP
• Hannah Kathryn Sadler, DPT
• Markie Lynn Sargent, ARNP
• Shawn Matthew Schany
• SD Rides LLC
• Michelle C Shryock, BA, TCADC
• Daunyale L Sporaa, DO
• Kathryn Nash Sticca, PHARMD
• Michelle Rae Theesfeld, MS LMHC
• Parker Sue Traub, DC

• Community/Retail Pharmacy in Emmetsburg, IA
• Providers in Emmetsburg, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.