Shopko Stores Operating Co Llc in Worthington - Community/retail Pharmacy
Shopko Stores Operating Co Llc - NPI 1063466852
Shopko Stores Operating Co Llc is a Community/retail Pharmacy in Worthington, Minnesota. Shopko Stores Operating Co Llc practices all healthcare services and medical treatments related to Community/retail Pharmacy. The NPI Number for Shopko Stores Operating Co Llc is 1063466852. The last update date is 2014-01-21.
Shopko Stores Operating Co Llc's current location address is 1755 N Humiston Ave, Worthington, Minnesota. You can contact this provider via phone number 5073769309 and fax number 5073727840. The mailing address for Shopko Stores Operating Co Llc is 1755 N Humiston Ave, Worthington, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shopko Stores Operating Co Llc |
|---|---|
| Address | 1755 N Humiston Ave, Worthington, Minnesota |
| Phone Number | 5073769309 |
| Fax Number | 5073727840 |
| 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 | 1063466852 |
|---|---|
| Provider Enumeration Date | 2006-05-19 |
| Last Updated Date | 2014-01-21 |
Provider Mailing Address Detail
| Address | 1755 N Humiston Ave |
|---|---|
| City | Worthington |
| State | Minnesota (MN) |
| Post Code | 561871757 |
| Phone Number | 5073769309 |
| Fax Number | 5073727840 |
Provider's Primary Taxonomy Detail
| Speciality | Community/retail Pharmacy |
|---|---|
| Taxonomy | 3336C0003X |
| Licence No | 2628040 |
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Definition: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing pr |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 60258200 | MN | -- | |
| 509463 | IA | -- | |
| 788690100 | MN | -- | |
| 166523500 | MN | -- | |
| 2416801 | NCPDP NUMBER | ||
| 722512 | IA | -- |
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What is the Shopko Stores Operating Co Llc's unique identification number?
The Shopko Stores Operating Co Llc has been assigned the NPI (National Provider Identifier) Number 1063466852 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete physical location address of Shopko Stores Operating Co Llc?
The Shopko Stores Operating Co Llc is physically situated at 1755 N Humiston Ave, in the city of Worthington, state of MN, with the postal code 561871757.
What is the Shopko Stores Operating Co Llc's specialty and taxonomy code?
The Shopko Stores Operating Co Llc's specialty is Community/retail Pharmacy, and the corresponding taxonomy code is 3336C0003X.
On what date did the Shopko Stores Operating Co Llc receive its 1063466852 assignment from the Centers for Medicare & Medicaid Services?
The Shopko Stores Operating Co Llc was assigned its 1063466852 by the Centers for Medicare & Medicaid Services on 2006-05-19.
As of what date were the details related to Shopko Stores Operating Co Llc most recently updated or revised?
The information pertaining to Shopko Stores Operating Co Llc, including its address, specialty, and other relevant details, was last updated or revised on 2014-01-21.