SHOPKO PHARMACY 061
NPI 1114971926
Pharmacy - Community/Retail Pharmacy in Saint Cloud, MN

NPI Status: Active since May 19, 2006

Contact Information

501 HIGHWAY 10 SE
SAINT CLOUD, MN
ZIP 56304
Phone: (320) 253-5373
Fax: (320) 253-4985

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy

About SHOPKO PHARMACY 061

This page provides the complete NPI Profile along with additional information for Shopko Pharmacy 061, a provider established in Saint Cloud, Minnesota operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1114971926 assigned on May 2006. The practitioner's primary taxonomy code is 3336C0003X with license number 2628066 (MN). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Shopko Pharmacy 061. The authorized official of this NPI record is Mr. Russell Steinhorst (Svp Chief Financial Officer)

NPI
1114971926
Provider Legal Name
SHOPKO STORES OPERATING CO LLC
Other Organization Name
SHOPKO PHARMACY 061
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
501 HIGHWAY 10 SE SAINT CLOUD, MN 56304
Location Phone
(320) 253-5373
Location Fax
(320) 253-4985
Mailing Address
501 HIGHWAY 10 SE SAINT CLOUD, MN 56304
Mailing Phone
(320) 253-5373
Mailing Fax
(320) 253-4985
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-19-2006
Last Update Date
09-14-2016
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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.
2628066
License State
MN
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)
1332B00000XSuppliers

Durable Medical Equipment & Medical Supplies

 
2332H00000XSuppliers

Eyewear Supplier

 

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. RUSSELL STEINHORST

Authorized Official Title
SVP CHIEF FINANCIAL OFFICER
Authorized Official Phone
(920) 429-7489

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
2416926OTHER (01)NCPDP NUMBER
597816500MEDICAID (05)MN 
5695760083MEDICARE NSC (07) 
1111590022MEDICARE ID-TYPE UNSPECIFIED (04) 
837430000MEDICAID (05)MN 
820258300MEDICAID (05)MN 

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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.
1114971926
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2124187294
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 2 + 4 + 1 + 8 + 7 + 2 + 9 + 4 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 66

The NPI number 1114971926 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1063465789SHOPKO STORES OPERATING CO. LLC
Organization
Eyewear Supplier501 HIGHWAY 10 SE
SAINT CLOUD, MN 56304
(320) 253-4695

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114971926, enumerated in the NPI registry as an "organization" on May 19, 2006

The provider is located at 501 Highway 10 Se Saint Cloud, Mn 56304 and the phone number is (320) 253-5373

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 19, 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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