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 212

Practice address

301 E US Highway 20
Gordon, NE 69343-1650

Phone

(920) 429-4726

NPI assigned

Aug 17, 2016

Last updated

Oct 14, 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 212 Doing business as

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1841745155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E US HIGHWAY 20",
            "city": "GORDON",
            "state": "NE",
            "postal_code": "693431650",
            "telephone_number": "920-429-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E US HIGHWAY 20",
            "city": "GORDON",
            "state": "NE",
            "postal_code": "693431650",
            "telephone_number": "920-429-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-10-14",
        "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 212",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Mary Sasse-Wallace, RDMS
• Abigail Schmidt
• Marjorie A Schmidt, PA-C
• Michelle Shelton
• Joseph Leon Shetler, OD
• Sylvia Strout
• Ashlei Tausan, RN
• Beatrice V Taylor, DO
• Jennifer Ellen Taylor, PLMHP, PLADC
• TWK Inc. (Stockmens Drug)

• Community/Retail Pharmacy in Gordon, NE
• Providers in Gordon, NE by specialty
• Community/Retail Pharmacy in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.