SHOPKO STORES OPERATING CO LLC NPI 1528013133

NPI Information

  • NPI: 1528013133
  • Provider Name: SHOPKO STORES OPERATING CO LLC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: SHOPKO PHARMACY 009
  • Address: 1306 N CENTRAL AVE
    MARSHFIELD, WI
    ZIP 54449
  • Phone: (715) 387-3705

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NPI Details

SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in Marshfield, WI. 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 1528013133. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 009.

The provider's business location address is:

1306 N CENTRAL AVE
MARSHFIELD, WI
ZIP 54449-507
Phone: (715) 387-3705
Fax: (715) 384-2007

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 5/23/2006 and was last updated on 7/25/2014.

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
1333600000XPharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3332H00000XEyewear SupplierNo
43336C0003XPharmacyCommunity/Retail Pharmacy8619042WISCONSINYes

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
15695760003MEDICARE NSC
20154160066MEDICARE ID-TYPE UNSPECIFIED
35107140OTHERNCPDP NUMBER
433134400MEDICAIDWISCONSIN

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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