SHOPKO PHARMACY 792
NPI 1265877435
Pharmacy - Community/Retail Pharmacy in Tomahawk, WI

NPI Status: Active since May 01, 2013

Contact Information

79 HOMETOWN DRIVE
TOMAHAWK, WI
ZIP 54487
Phone: (715) 453-5996

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy

About SHOPKO PHARMACY 792

This page provides the complete NPI Profile along with additional information for Shopko Pharmacy 792, a provider established in Tomahawk, Wisconsin operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1265877435 assigned on May 2013. The practitioner's primary taxonomy code is 3336C0003X. The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's is doing business as Shopko Pharmacy 792. The authorized official of this NPI record is Michael Bettiga Rph (Executive Vice President And Coo)

NPI
1265877435
Provider Legal Name
SHOPKO STORES OPERATING CO LLC
Other Organization Name
SHOPKO PHARMACY 792
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
79 HOMETOWN DRIVE TOMAHAWK, WI 54487
Location Phone
(715) 453-5996
Mailing Address
79 HOMETOWN DRIVE TOMAHAWK, WI 54487
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-01-2013
Last Update Date
11-18-2013
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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
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

 
2333600000XSuppliers

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.

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

MICHAEL BETTIGA RPH

Authorized Official Title
EXECUTIVE VICE PRESIDENT AND COO
Authorized Official Phone
(920) 429-7297

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
1265877435MEDICAID (05)WI 
5695760290MEDICARE NSC (07)WI 

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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.
1265877435
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221251671446
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 2 + 5 + 1 + 6 + 7 + 1 + 4 + 4 + 6 + 24 = 65
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 65 = 55

The NPI number 1265877435 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265877435, enumerated in the NPI registry as an "organization" on May 01, 2013

The provider is located at 79 Hometown Drive Tomahawk, Wi 54487 and the phone number is (715) 453-5996

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 01, 2013. 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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