Shopko Stores Operating Co LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SHOPKO STORES OPERATING CO LLC

Practice address

717 E Lakeshore Dr
Manistique, MI 49854-1682

Phone

(906) 341-3994

Fax

(906) 341-3996

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Russell Steinhorst

Title

SVP and Coo

Phone

(920) 429-7489

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shopko Pharmacy 2621 Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Pamida Stores Operating Co LLC

  • Community/Retail Pharmacy
  • California, MO
  • NPI 1336187707

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450137600000",
    "number": "1649223249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 E LAKESHORE DR",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498541682",
            "telephone_number": "906-341-3994",
            "fax_number": "906-341-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 E LAKESHORE DR",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498541682",
            "telephone_number": "906-341-3994",
            "fax_number": "906-341-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-12-15",
        "status": "A",
        "authorized_official_last_name": "STEINHORST",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP AND COO",
        "authorized_official_telephone_number": "920-429-7489",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "0459230120",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shopko Pharmacy 2621",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Schoolcraft Memorial Hospital
• Schoolcraft Memorial Hospital
• Schoolcraft Memorial Hospital
• Schoolcraft Memorial Hospital
• Shelly D. Baker, OD, PC
• Smile Select PLLC
• Dennis Duane Smith, FNP-BC
• Hope Angela St. Amour, LLMSW
• Ressie Stranaly, PMHNP-BC
• Alyssa Strasser, LLMSW

• Community/Retail Pharmacy in Manistique, MI
• Providers in Manistique, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.