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Shopko Stores Operating Co LLC

Shopko Stores Operating Co LLC is a healthcare organization registered as Community/Retail Pharmacy in Princeton, MN, holding Type 2 (organization) NPI 1376842286 since 2011. The authorized official on file is Michael Bettiga, Executive Vp & Coo.

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NPI 1376842286
Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 705 NORTHLAND DR, Princeton, MN, 55371
Phone 7633893111
Fax 7633891621
Enumeration date 2011-03-17
Last updated in NPPES 2011-12-09

Authorized official

Name Michael Bettiga
Title Executive Vp & Coo
Phone 9204294297

Taxonomy & classification

Taxonomy code Specialty Primary License State
332B00000X Durable Medical Equipment & Medical Supplies Secondary
333600000X Pharmacy Secondary 263663 MN
3336C0003X Community/Retail Pharmacy Primary 263663 MN

Other identifiers

Identifier Type State Issuer
2430786 Other NCPDP PROVIDER IDENTIFICATION NUMBER
1376842286 Medicaid MN
Copy-ready billing details
Provider: Shopko Stores Operating Co LLC
NPI: 1376842286
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 705 NORTHLAND DR, Princeton, MN, 55371

Providers at this address

NPI Name Type Specialty Location
1003869272 Pamida Stores Operating Co LLC Organization Community/Retail Pharmacy Princeton, MN
1700043734 Jacalyn Nelson Individual Pharmacist Princeton, MN

Verify this record

Cross-check NPI 1376842286 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

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Shopko Stores Operating Co LLC?
Shopko Stores Operating Co LLC is registered in NPPES as a Community/Retail Pharmacy (its primary provider taxonomy).

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2011-12-09.