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 #2205

Practice address

94 North 400 East
Delta, UT 84624

Phone

(920) 429-4726

NPI assigned

Aug 31, 2016

Last updated

Nov 15, 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

92044294726

Specialties & licenses 3

Addresses

Other names 1

• SHOPKO PHARMACY #2205 Doing business as

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1740736586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 NORTH 400 EAST",
            "city": "DELTA",
            "state": "UT",
            "postal_code": "84624",
            "telephone_number": "920-429-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 NORTH 400 EAST",
            "city": "DELTA",
            "state": "UT",
            "postal_code": "84624",
            "telephone_number": "920-429-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-11-15",
        "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": "92044294726"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOPKO PHARMACY #2205",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scoville Chiropractic Clinic LLP
• Service Drug Company Inc (Service Drug LTC)
• Service Drug Company Inc
• Service Drug Company Inc (Service Drug Co - Lab)
• Steven W Shamo, M.D.
• Shreya Health of Utah, Inc
• Renae G. Singletary, LCSW
• Alan Ross Smith, M.D.
• Erin Nicole Sorenson, PTA
• Randy Dale Stinson, D.P.T.

• Community/Retail Pharmacy in Delta, UT
• Providers in Delta, 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 Nov 15, 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.