SHOPKO STORES OPERATING CO LLC NPI 1003869025

NPI Information

  • NPI: 1003869025
  • Provider Name: SHOPKO STORES OPERATING CO LLC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: SHOPKO PHARMACY 518
  • Address: 100 EVERGREEN SQ SW
    PINE CITY, MN
    ZIP 55063
  • Phone: (320) 629-3003

Map and Directions

Get Directions

NPI Details

SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in Pine City, MN. The provider is 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. SHOPKO STORES OPERATING CO LLC NPI is 1003869025. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 518.

The provider's business location address is:

100 EVERGREEN SQ SW
PINE CITY, MN
ZIP 55063-000
Phone: (320) 629-3003
Fax: (320) 629-2987

The provider's authorized official is Michael Bettiga .
The authorized official title is Executive Vice President & Coo and has the following contact phone number (920) 429-4297.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 7/31/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy262789-2MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15695760161MEDICARE NSC
22418829OTHERNCPDP
30459230007MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI