SHOPKO PHARMACY 506
NPI 1356505408
Pharmacy - Community/Retail Pharmacy in Green Bay, WI

NPI Status: Active since July 17, 2008

Contact Information

300 N BROADWAY
GREEN BAY, WI
ZIP 54303
Phone: (920) 430-1505
Fax: (920) 430-1773

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy

About SHOPKO PHARMACY 506

This page provides the complete NPI Profile along with additional information for Shopko Pharmacy 506, a provider established in Green Bay, Wisconsin operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1356505408 assigned on July 2008. The practitioner's primary taxonomy code is 3336C0003X. 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 506. The authorized official of this NPI record is Mr. Michael Bettiga Rph (Sr. Vice President Health Services)

NPI
1356505408
Provider Legal Name
SHOPKO STORES OPERATING CO LLC
Other Organization Name
SHOPKO PHARMACY 506
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
300 N BROADWAY GREEN BAY, WI 54303
Location Phone
(920) 430-1505
Location Fax
(920) 430-1773
Mailing Address
300 N BROADWAY GREEN BAY, WI 54303
Mailing Phone
(920) 430-1505
Mailing Fax
(920) 430-1773
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-17-2008
Last Update Date
01-05-2009
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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

MR. MICHAEL BETTIGA RPH

Authorized Official Title
SR. VICE PRESIDENT HEALTH SERVICES
Authorized Official Phone
(920) 429-4297

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
5695760144MEDICARE NSC (07) 
5131026OTHER (01)NCPDP
36230700MEDICAID (05)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.
1356505408
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
231061001040
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 0 + 6 + 1 + 0 + 0 + 1 + 0 + 4 + 0 + 24 = 42
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 42 = 88

The NPI number 1356505408 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1124016407OCONTO PHYSICAL THERAPY, LLC
Organization
Physical Therapist300 N BROADWAY SUITE 3C
GREEN BAY, WI 54303
(920) 437-7246
1184731945MS. CHERYL M CONARD P.T.
Individual
Physical Therapist300 N BROADWAY SUITE 3C
GREEN BAY, WI 54303
(920) 437-7246

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356505408, enumerated in the NPI registry as an "organization" on July 17, 2008

The provider is located at 300 N Broadway Green Bay, Wi 54303 and the phone number is (920) 430-1505

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 July 17, 2008. 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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