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 798

Practice address

1635 E Highway 40
Ballard, UT 84066-5217

Phone

(920) 429-4726

NPI assigned

Aug 26, 2016

Last updated

Aug 26, 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

Director of Third Party

Phone

(920) 429-4726

Specialties & licenses 3

Addresses

Other names 1

• SHOPKO PHARMACY 798 Doing business as

Member of 1

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

• Shopko Stores Operating Co LLC

  dba Shopko Pharmacy 718

  • Community/Retail Pharmacy
  • Liberty, KY
  • NPI 1508819384

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472169600000",
    "number": "1649726076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 E HIGHWAY 40",
            "city": "BALLARD",
            "state": "UT",
            "postal_code": "840665217",
            "telephone_number": "920-429-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 E HIGHWAY 40",
            "city": "BALLARD",
            "state": "UT",
            "postal_code": "840665217",
            "telephone_number": "920-429-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-26",
        "last_updated": "2016-08-26",
        "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 798",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Adams, LMT
• Uintah Basin Medical Center (UBMC Physical Therapy)

• Community/Retail Pharmacy in Ballard, UT
• Providers in Ballard, UT by specialty
• Community/Retail Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.