Organization · Type 2 NPI

Shopko Stores Operating Co., LLC

Community/Retail Pharmacy · Shawano, WI

NPI number 1003349101 Active

Practice location

100 County Road B
Shawano, WI 54166-7072

Call (920) 429-4726 Map

Mailing address

100 County Road B Ste W181
Shawano, WI 54166-7072

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: 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 process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

108 other providers at this address

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NPI record

NPI: 1003349101
Entity type: Organization (Type 2)
Issued: Apr 5, 2017
Last updated: Apr 27, 2018
Status: Active

Other names

<unavail>
Shopko Pharmacy 2215 · doing business as
Shopko Pharmacy 2215 · doing business as

Authorized official

Jannie Delane Paschal
VP Managed Care
(920) 429-4726

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003349101

Shopko Stores Operating Co., LLC's National Provider Identifier is 1003349101, issued on Apr 5, 2017. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Shawano, WI. The record was last updated on Apr 27, 2018.