Shopko Pharmacy 716

LBN: Shopko Stores Operating Co Llc
Shopko Pharmacy 716 is an health care organization with primary practice located at 1520 W 9Th St , Mount Carmel IL 62863-2909. 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 (618) 262-2475, or through Neumann, Lorie via phone (920) 429-4726.

Contact Information

Primary practice address
1520 W 9Th St Mount Carmel IL 62863-2909
Phone: (618) 262-2475
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Neumann, Lorie
Phone: (920) 429-4726

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1174941231
LBN Legal business name Shopko Stores Operating Co Llc
DBA Doing business as Shopko Pharmacy 716
Authorized official Neumann, Lorie
Entity Organization
Organization subpart 1 No
Enumeration date Apr 4th, 2014
Last updated Sep 4th, 2015 - about 11 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 1174941231 NPPES
Illinois Other P00836438 RAIL ROAD MEDICARE

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