Organization
SHOPKO STORES OPERATING CO LLC
Active
Other names
ShopKo Pharmacy 061
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL STEINHORST (SVP CHIEF FINANCIAL OFFICER)
(920) 429-7489
Entity
Organization
Contact information
Practice address
501 HIGHWAY 10 SE, SAINT CLOUD, MN 56304-1250
(320) 253-5373
(320) 253-4985
Mailing address
501 HIGHWAY 10 SE, SAINT CLOUD, MN 56304-1250
(320) 253-5373
(320) 253-4985
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332H00000X
Eyewear Supplier
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2628066
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2416926
NCPDP NUMBER
—
05
—
597816500
—
MN
05
—
820258300
—
MN
05
—
837430000
—
MN
Enumeration date
05/19/2006
Last updated
09/14/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us