Shopko Pharmacy 132

LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 132 is an health care organization with primary practice located at 320 S Access Rd , Rice Lake WI 54868-8572. 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 (715) 236-7414, or through Steinhorst, Russell via phone (920) 429-7489.

Contact Information

Primary practice address
320 S Access Rd Rice Lake WI 54868-8572
Phone: (715) 236-7414
Fax: (715) 236-7714
Website:
Map and Directions
Authorized official contact:
Name: Steinhorst, Russell
Phone: (920) 429-7489

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 8603042 Wisconsin

Profile Details

NPI number 1780639906
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as Shopko Pharmacy 132
Authorized official Steinhorst, Russell
Entity Organization
Organization subpart 1 No
Enumeration date May 24th, 2006
Last updated Jun 12th, 2017 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780639906 NPPES
Other 5122229 NCPDP NUMBER
MEDICAID 33203200 NCPDP NUMBER

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