{"npi":"1619928330","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":"332H00000X","description":"Eyewear Supplier","primary":false,"state":null,"license":null},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"IA","license":"819"}]},"addresses":[{"purpose":"LOCATION","street_1":"615 S MONROE AVE","city":"MASON CITY","state":"IA","postal_code":"504015061","country_code":"US","phone":"6414244302","fax":"6414248537"},{"purpose":"MAILING","street_1":"615 S MONROE AVE","city":"MASON CITY","state":"IA","postal_code":"504015061","country_code":"US","phone":"6414244302","fax":"6414248537"}],"license":{"state":"IA","number":"819"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"0227249","state":"IA","issuer":null},{"type_code":"05","label":"Medicaid","value":"0495168","state":"IA","issuer":null},{"type_code":"05","label":"Medicaid","value":"743927000","state":"MN","issuer":null},{"type_code":"01","label":"Other","value":"1614494","state":null,"issuer":"NCPDP NUMBER"},{"type_code":"05","label":"Medicaid","value":"201016000","state":"MN","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-05-15","last_updated":"2014-06-06","_meta":{"source":"NPPES","snapshot_date":"2014-06-06","doc_url":"https://findmynpi.com/api"}}