Shopko Pharmacy 072
LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 072 is an health care organization with primary practice located at 2120 Thain Grade , Lewiston ID 83501-4105. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Eyewear Supplier (Equipment, not the service), Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Shopko Stores Operating Co Llc can be contacted via phone (208) 746-1044, or through Bettiga, Michael J via phone (920) 429-4297.
Contact Information
Primary practice address
2120 Thain Grade
Lewiston ID 83501-4105
Phone: (208) 746-1044
Fax: (208) 746-0744
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X | ||
| Suppliers / Pharmacy | 333600000X | 2036CP | Idaho |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 2036CP | Idaho |
Profile Details
| NPI number | 1144275884 |
|---|---|
| LBN Legal business name | Shopko Stores Operating Co Llc |
| DBA Doing business as | Shopko Pharmacy 072 |
| Authorized official | Bettiga, Michael J RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 23rd, 2006 |
| Last updated | Jun 6th, 2014 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144275884 | NPPES |
| Idaho | MEDICAID | 000311600 | |
| Idaho | MEDICAID | 806730900 | |
| Idaho | Other | 0215803 | |
| Idaho | Other | 0004888 | |
| Idaho | Other | 1304651 |
Popular Providers
-
Chastains Incorporated
720 16Th Ave Ste 1 , Lewiston ID 83501-3768 -
Bioscrip Pharmacy, Inc.
8490 Santa Monica Blvd Ste 1, West Hollywood CA 90069-4261 -
La Quinta Pharmacy
78150 Calle Tampico Ste 103, La Quinta CA 92253-2907 -
Albertsons Llc
1024 21St St , Lewiston ID 83501 -
Walgreen Co
2102 Nez Perce Dr , Lewiston ID 83501-4116 -
Bioscrip Pharmacy, Inc.
4940 Van Nuys Blvd Ste 104, Sherman Oaks CA 91403-1700 -
Thrifty Payless Inc
1904 19Th Avenue Lewiston Center, Lewiston ID 83501-4069 -
Bioscrip Pharmacy, Inc.
1874 Piedmont Ave Ne Bldg A Suite A, Atlanta GA 30324-4869