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Shopko Stores Operating Co LLC

Community/Retail Pharmacy in Worthington, MN · enumerated 2006 · authorized official Michael Bettiga, Sr. Vice President Health Services.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1063466852

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Registry record

Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 1755 N Humiston Ave, Worthington, MN, 56187
Fax (507) 372-7840
Enumeration date May 19, 2006
Last updated in NPPES Jan 21, 2014

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
332H00000X Eyewear Supplier Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 2628040 (MN) Primary

Authorized official

Name Michael Bettiga
Title Sr. Vice President Health Services

Other identifiers

Identifier Type State Issuer
060258200 Medicaid MN -
0509463 Medicaid IA -
788690100 Medicaid MN -
166523500 Medicaid MN -
2416801 Other - NCPDP NUMBER
0722512 Medicaid IA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Shopko Stores Operating Co LLC?
The NPI for Shopko Stores Operating Co LLC is 1063466852, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Shopko Stores Operating Co LLC?
NPPES lists Michael Bettiga (Sr. Vice President Health Services) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-01-21.