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Shopko Stores Operating Co LLC

Community/Retail Pharmacy in Powell, WY · enumerated 2006 · authorized official Michael Bettiga, Executive Vice President & Coo.

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

National Provider Identifier

1124067095

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Registry record

Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 1005 W Coulter Ave, Powell, WY, 82435
Phone (307) 754-2755
Fax (307) 754-7915
Enumeration date Jun 6, 2006
Last updated in NPPES Oct 19, 2012

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
333600000X Pharmacy Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers Primary

Authorized official

Name Michael Bettiga
Title Executive Vice President & Coo
Phone (920) 429-4297

Other identifiers

Identifier Type State Issuer
123286000 Medicaid WY -
5203776 Other - NCPDP
117709500 Medicaid WY -
123286001 Medicaid WY -

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

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2012-10-19. Verify at npiregistry.cms.hhs.gov.
Where is Shopko Stores Operating Co LLC located?
The practice location on file with NPPES is in Powell, WY.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-10-19.