SHOPKO PHARMACY 615
NPI 1821042003
Pharmacy - Community/Retail Pharmacy in Clintonville, WI
NPI Status: Active since May 20, 2006
Contact Information
291 S MAIN ST
CLINTONVILLE, WI
ZIP 54929
Phone: (715) 823-2350
Fax: (715) 823-2541
- Organization
- Pharmacy
- Community/Retail Pharmacy
About SHOPKO PHARMACY 615
This page provides the complete NPI Profile along with additional information for Shopko Pharmacy 615, a provider established in Clintonville, Wisconsin operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1821042003 assigned on May 2006. The practitioner's primary taxonomy code is 3336C0003X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Shopko Pharmacy 615. The authorized official of this NPI record is Mr. Michael Bettiga Rph (Executive Vice President & Coo)
- NPI
- 1821042003
- Provider Legal Name
- SHOPKO STORES OPERATING CO LLC
- Other Organization Name
- SHOPKO PHARMACY 615
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 291 S MAIN ST CLINTONVILLE, WI 54929
- Location Phone
- (715) 823-2350
- Location Fax
- (715) 823-2541
- Mailing Address
- 291 S MAIN ST CLINTONVILLE, WI 54929
- Mailing Phone
- (715) 823-2350
- Mailing Fax
- (715) 823-2541
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-20-2006
- Last Update Date
- 09-24-2012
- 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
- 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 |
|---|---|---|---|
| 5127267 | OTHER (01) | NCPDP NUMBER | |
| 5695760195 | MEDICARE NSC (07) | ||
| 33268600 | MEDICAID (05) | WI | |
| 5694490087 | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
| 0459230113 | MEDICARE ID-TYPE UNSPECIFIED (04) |
Reviews for SHOPKO PHARMACY 615
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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 | 8 | 2 | 1 | 0 | 4 | 2 | 0 | 0 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 4 | 1 | 0 | 4 | 4 | 0 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 4 + 1 + 0 + 4 + 4 + 0 + 0 + 24 = 47 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 47 = 3 | 3 | ||||||||
The NPI number 1821042003 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1285988857 | LEONARD J PURULL RPH Individual | Pharmacist | 291 S MAIN ST CLINTONVILLE, WI 54929 (715) 823-2350 |
| 1679917108 | MRS. CASEY ANNE BARTZ PHARM D Individual | Pharmacist | 291 S MAIN ST CLINTONVILLE, WI 54929 (715) 823-2350 |
| 1508298779 | BOBBI R. BRAHAN PHARMD Individual | Pharmacist | 291 S MAIN ST CLINTONVILLE, WI 54929 (715) 823-2350 |
| 1982056362 | CURTIS LEIDER Individual | Pharmacist | 291 S MAIN ST CLINTONVILLE, WI 54929 (715) 823-2350 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1821042003, enumerated in the NPI registry as an "organization" on May 20, 2006
The provider is located at 291 S Main St Clintonville, Wi 54929 and the phone number is (715) 823-2350
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 20, 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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