SHOPKO PHARMACY 007
NPI 1093761447
Pharmacy - Community/Retail Pharmacy in La Crosse, WI
NPI Status: Active since May 26, 2006
Contact Information
4344 MORMON COULEE RD
LA CROSSE, WI
ZIP 54601
Phone: (608) 788-8860
Fax: (608) 788-5790
- Organization
- Pharmacy
- Community/Retail Pharmacy
About SHOPKO PHARMACY 007
This page provides the complete NPI Profile along with additional information for Shopko Pharmacy 007, a provider established in La Crosse, Wisconsin operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1093761447 assigned on May 2006. The practitioner's primary taxonomy code is 3336C0003X with license number 8635042 (WI). The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as Shopko Pharmacy 007. The authorized official of this NPI record is Mr. Michael J Bettiga Rph (Sr. Vice President Health Services)
- NPI
- 1093761447
- Provider Legal Name
- SHOPKO STORES OPERATING CO LLC
- Other Organization Name
- SHOPKO PHARMACY 007
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4344 MORMON COULEE RD LA CROSSE, WI 54601
- Location Phone
- (608) 788-8860
- Location Fax
- (608) 788-5790
- Mailing Address
- 4344 MORMON COULEE RD LA CROSSE, WI 54601
- Mailing Phone
- (608) 788-8860
- Mailing Fax
- (608) 788-5790
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-26-2006
- Last Update Date
- 08-06-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Community/Retail Pharmacy
- Taxonomy Code
- 3336C0003X
- Type
- Suppliers
- License No.
- 8635042
- License State
- WI
- Taxonomy Description
- 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 health care providers, collaborative practice, disease state management, and education classes.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| 2 | 333600000X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 33005100 | MEDICAID (05) | WI | |
| 732060400 | MEDICAID (05) | MN | |
| 0154160109 | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
| 511663000 | MEDICAID (05) | MN | |
| 5113270 | OTHER (01) | NCPDP NUMBER | |
| 5695760001 | MEDICARE NSC (07) |
Reviews for SHOPKO PHARMACY 007
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 9 | 3 | 7 | 6 | 1 | 4 | 4 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 18 | 3 | 14 | 6 | 2 | 4 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 8 + 3 + 1 + 4 + 6 + 2 + 4 + 8 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1093761447 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1528018975 | COLLEEN NICOLE KONKEL O.D. Individual | Optometrist | 4344 MORMON COULEE RD LA CROSSE, WI 54601 (608) 788-8800 |
| 1548213184 | SHOPKO STORES OPERATING CO. LLC Organization | Eyewear Supplier | 4344 MORMON COULEE RD LA CROSSE, WI 54601 (608) 788-8800 |
| 1386997294 | RYAN BARFKNECHT Individual | Pharmacist | 4344 MORMON COULEE RD LA CROSSE, WI 54601 (608) 788-8860 |
| 1346686300 | MR. MARC CHRISTOPHER ERTZ R.PH. Individual | Pharmacist | 4344 MORMON COULEE RD LA CROSSE, WI 54601 (608) 788-8860 |
| 1063851020 | MR. MATTHEW JOHN FERNHOLZ RPH Individual | Pharmacist | 4344 MORMON COULEE RD LA CROSSE, WI 54601 (608) 188-8860 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093761447, enumerated in the NPI registry as an "organization" on May 26, 2006
The provider is located at 4344 Mormon Coulee Rd La Crosse, Wi 54601 and the phone number is (608) 788-8860
This medical organization specializes in Pharmacy with taxonomy code 3336C0003X with a focus in Community/Retail Pharmacy
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on May 26, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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