{"npi":"1215983663","type":"NPI-2","status":"active","name":{"display":"Shopko Stores Operating Co LLC","other":[],"organization_name":"SHOPKO STORES OPERATING CO LLC","authorised_official":"Michael Bettiga"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":false,"state":null,"license":null},{"code":"333600000X","description":"Pharmacy","primary":false,"state":null,"license":null},{"code":"332H00000X","description":"Eyewear Supplier","primary":false,"state":null,"license":null},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"WI","license":"8615042"}]},"addresses":[{"purpose":"LOCATION","street_1":"200 S 18TH AVE","city":"WAUSAU","state":"WI","postal_code":"544014252","country_code":"US","phone":"7158427737","fax":"7158488773"},{"purpose":"MAILING","street_1":"200 S 18TH AVE","city":"WAUSAU","state":"WI","postal_code":"544014252","country_code":"US","phone":"7158427737","fax":"7158488773"}],"license":{"state":"WI","number":"8615042"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"33158000","state":"WI","issuer":null},{"type_code":"01","label":"Other","value":"5119070","state":null,"issuer":"NCPDP"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-05-26","last_updated":"2014-06-11","_meta":{"source":"NPPES","snapshot_date":"2014-06-11","doc_url":"https://findmynpi.com/api"}}