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SHOPKO PHARMACY 2215
NPI 1003349101
Pharmacy - Community/Retail Pharmacy in Shawano, WI

Active since April 05, 2017
100 COUNTY ROAD B, SHAWANO, WI 54166(920) 429-4726 Get Directions Write a Review

NPPES record last updated: April 27, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Pharmacy 2215 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOPKO PHARMACY 2215 (NPI 1003349101) is a healthcare organization registered as a community/retail pharmacy in Shawano, Wisconsin and active in the NPI registry since April 2017. The organization lists Jannie Delane Paschal, Vp Managed Care, as its authorized official.

NPPES Registry Identity

NPI1003349101
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO., LLC
Location Address100 COUNTY ROAD BShawano, WI 54166-7072
Mailing Address100 County Road B Ste W181Shawano, WI 54166-7072 · (715) 526-3456
Phone(920) 429-4726
Organization SubpartNo
Authorized OfficialJannie Delane PaschalVp Managed Care · (920) 429-4726
Enumeration DateApril 5, 2017
Last NPPES UpdateApril 27, 2018
✔ NPI 1003349101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
100 COUNTY ROAD B, Shawano, WI 54166
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Other Names 1

Doing Business AsShopko Pharmacy 2215

Other Identifiers 1

Medicaid1003349101WI

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. DAVID A KLOSS M.D.
Surgery
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 524-2161
DR. MINDY MARIA FRIMODIG DO
Family Medicine
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 524-2161
CAROLYN ANNE FLOOD OTR/L
Occupational Therapist
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 526-7370
WILL GILLIS PHARMD
Pharmacist
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 526-3456
RACHEL NAULT PHARMD
Pharmacist
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 524-2161
ALEXIS VANDEHEY
Pharmacist
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (920) 203-0630
JENNA J MULDER
Physician Assistant
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 526-2111
SUSAN IRENE GILLETTE PTA
Physical Therapy Assistant
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 526-7370

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shopko Stores Operating Co., LLC's NPI number?

The NPI number for Shopko Stores Operating Co., LLC is 1003349101. It was assigned to this organization in the NPPES registry on April 5, 2017. The provider is doing business as Shopko Pharmacy 2215.

Where is Shopko Stores Operating Co., LLC located?

Shopko Stores Operating Co., LLC is located at 100 County Road B, Shawano, WI 54166. The listed phone number is (920) 429-4726.

What is Shopko Stores Operating Co., LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co., LLC was last updated on April 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.