Shopko Stores Operating Co LLC
Shopko Stores Operating Co LLC is a healthcare organization registered as Community/Retail Pharmacy in Tomahawk, WI, holding Type 2 (organization) NPI 1265877435 since 2013. The authorized official on file is Michael Bettiga, Executive Vice President and Coo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1265877435 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Shopko Stores Operating Co LLC |
| Other name | <Unavail> |
| Practice address | 79 HOMETOWN DRIVE, Tomahawk, WI, 54487 |
| Phone | 7154535996 |
| Enumeration date | 2013-05-01 |
| Last updated in NPPES | 2013-11-18 |
Authorized official
| Name | Michael Bettiga |
|---|---|
| Title | Executive Vice President and Coo |
| Phone | 9204297297 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265877435 | Medicaid | WI | — |
Copy-ready billing details
Provider: Shopko Stores Operating Co LLC NPI: 1265877435 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 79 HOMETOWN DRIVE, Tomahawk, WI, 54487
Verify this record
Cross-check NPI 1265877435 against the authoritative CMS record: view Shopko Stores Operating Co LLC on the official NPPES registry .
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. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Shopko Stores Operating Co LLC?
What is the NPI number for Shopko Stores Operating Co LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2013-11-18.