SHOPKO STORES OPERATING CO LLC NPI 1265486039

NPI Information

  • NPI: 1265486039
  • Provider Name: SHOPKO STORES OPERATING CO LLC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: SHOPKO PHARMACY 041
  • Address: 1209 18TH AVE NW
    AUSTIN, MN
    ZIP 55912
  • Phone: (507) 437-7616

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NPI Details

SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in Austin, 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 1265486039. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 041.

The provider's business location address is:

1209 18TH AVE NW
AUSTIN, MN
ZIP 55912-881
Phone: (507) 437-7616
Fax: (507) 437-8565

The provider's authorized official is Michael J Bettiga .
The authorized official title is Sr. Vice President Health Services 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 8/27/2013.

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
2332H00000XEyewear SupplierNo
33336C0003XPharmacyCommunity/Retail Pharmacy2628024MINNESOTAYes

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
11111590005MEDICARE ID-TYPE UNSPECIFIED
20722652MEDICARE ID-TYPE UNSPECIFIEDIOWA
3608057000MEDICAIDMINNESOTA
4840020000MEDICAIDMINNESOTA
52416116OTHERNCPDP NUMBER
6126023500MEDICAIDMINNESOTA
70578674MEDICAIDIOWA
85695760050MEDICARE NSC

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

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