Shopko Pharmacy
LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy is an health care organization with primary practice located at 705 Northland Dr , Princeton MN 55371-2168. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, 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 (763) 389-3111, or through Bettiga, Michael via phone (920) 429-4297.
Contact Information
Primary practice address
705 Northland Dr
Princeton MN 55371-2168
Phone: (763) 389-3111
Fax: (763) 389-1621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | 263663 | Minnesota |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 263663 | Minnesota |
Profile Details
| NPI number | 1376842286 |
|---|---|
| LBN Legal business name | Shopko Stores Operating Co Llc |
| DBA Doing business as | Shopko Pharmacy |
| Authorized official | Bettiga, Michael |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 17th, 2011 |
| Last updated | Dec 9th, 2011 - about 13 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 | 1376842286 | NPPES |
| Other | 2430786 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 1376842286 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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