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 #2559

Practice address

429 Michigan Ave
Orofino, ID 83544-0000

Phone

(208) 476-5727

NPI assigned

Jul 17, 2015

Last updated

Oct 11, 2016By the provider in NPPES

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

Dir 3D Party Contract & Ca

Phone

(920) 429-4726

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shopko Pharmacy #2559 Doing business as

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew Cyr, PHARMACIST

  • Pharmacist
  • Orofino, ID
  • NPI 1538686696
  NPD (past)
• Sherri Mills

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Orofino, ID
  • NPI 1043762982
  NPD (past)
• Ernest Upshaw, PHARMD

  • Pharmacist
  • Orofino, ID
  • NPI 1497233563
  NPD (past)

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1629452776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 MICHIGAN AVE",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "835440000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 MICHIGAN AVE",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "835440000",
            "telephone_number": "208-476-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "NEUMANN",
        "authorized_official_first_name": "LORIE",
        "authorized_official_title_or_position": "DIR 3D PARTY CONTRACT & CA",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629452776",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shopko Pharmacy #2559",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert M. Schmidt, LCSW, CADC
• Noah Schuerman
• Brian Shapiro
• Michelle Rene Sheffer, LMSW
• Colleen Patricia Devine Sholar, DO
• Jean M. Shropshire, S/LP
• Robert A Shropshire III
• Paul E Smith, MD
• State of Idaho Department of Health and Welfare (State Hospital North)
• Alison Thomas, PT

• Community/Retail Pharmacy in Orofino, ID
• Providers in Orofino, ID by specialty
• Community/Retail Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.