Shopko Stores Operating Co. Llc in East Peoria - Durable Medical Equipment & Medical Supplies
Shopko Stores Operating Co. Llc - NPI 1972539740
Shopko Stores Operating Co. Llc is a Durable Medical Equipment & Medical Supplies in East Peoria, Illinois. Shopko Stores Operating Co. Llc practices all healthcare services and medical treatments related to Durable Medical Equipment & Medical Supplies. The NPI Number for Shopko Stores Operating Co. Llc is 1972539740. The last update date is 2020-08-22.
Shopko Stores Operating Co. Llc's current location address is 105 N Main St, East Peoria, Illinois. You can contact this provider via phone number 3096990632 and fax number 3096946426. The mailing address for Shopko Stores Operating Co. Llc is 105 N Main St, East Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shopko Stores Operating Co. Llc |
|---|---|
| Address | 105 N Main St, East Peoria, Illinois |
| Phone Number | 3096990632 |
| Fax Number | 3096946426 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | SR. VICE P |
|---|---|
| Authorized Official Name | Bettiga J Michael |
| Credentials | RPH |
| Telephone Number | 9204294297 |
NPI Number Detail
| NPI Number | 1972539740 |
|---|---|
| Provider Enumeration Date | 2006-06-24 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 105 N Main St |
|---|---|
| City | East Peoria |
| State | Illinois (IL) |
| Post Code | 616112543 |
| Phone Number | 3096990632 |
| Fax Number | 3096946426 |
Provider's Primary Taxonomy Detail
| Speciality | Durable Medical Equipment & Medical Supplies |
|---|---|
| Taxonomy | 332B00000X |
|
Definition: A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1472048 | NCPDP NUMBER | ||
| 410985054173 | IL | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Shopko Stores Operating Co. Llc by the Centers for Medicare & Medicaid Services?
The Shopko Stores Operating Co. Llc has been issued the NPI (National Provider Identifier) 1972539740, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Shopko Stores Operating Co. Llc located?
The Shopko Stores Operating Co. Llc is located at 105 N Main St, East Peoria, IL 616112543.
What is Shopko Stores Operating Co. Llc's area of expertise and its corresponding taxonomy classification?
The Shopko Stores Operating Co. Llc's field of specialization is Durable Medical Equipment & Medical Supplies, and it falls under the taxonomy code 332B00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Shopko Stores Operating Co. Llc receive its 1972539740 assignment from the Centers for Medicare & Medicaid Services?
The Shopko Stores Operating Co. Llc was assigned its 1972539740 by the Centers for Medicare & Medicaid Services on 2006-06-24.
As of what date was the information regarding Shopko Stores Operating Co. Llc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Shopko Stores Operating Co. Llc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-08-22.
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