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 739

Practice address

710 County Road 21 S
Glenwood, MN 56334-9145

Phone

(320) 634-4399

Fax

(320) 634-4425

NPI assigned

May 18, 2006

Last updated

Apr 30, 2018By 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

Jannie Delane Paschal

Title

VP

Phone

(920) 429-4726

Specialties & licenses 3

Addresses

Other names 1

• Shopko Pharmacy 739 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 680

  • Community/Retail Pharmacy
  • Perry, IA
  • NPI 1902859317

  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": "1525046400000",
    "number": "1982657045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COUNTY ROAD 21 S",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563349145",
            "telephone_number": "320-634-4399",
            "fax_number": "320-634-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 COUNTY ROAD 21 S",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563349145",
            "telephone_number": "320-634-4399",
            "fax_number": "320-634-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "PASCHAL",
        "authorized_official_first_name": "JANNIE",
        "authorized_official_middle_name": "DELANE",
        "authorized_official_title_or_position": "VP",
        "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 739",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shopko Pharmacy 739",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebekah Ruth Rick, PA
• Scott William Ringdahl, DR DENTIST
• Melissa A Saari
• Jeffrey Alan Schlueter, M.D.
• Joseph Anthony Schneiderhan, O.D.
• Rebeka A Srbu, DO
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Glenwood Lakeview)
• Joshua David Thomas, D.O.
• Jodie Louise Trill, RN
• Trumm Drug, Inc. (Trumm Drug Glenwood)

• Community/Retail Pharmacy in Glenwood, MN
• Providers in Glenwood, MN by specialty
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.