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Shopko Stores Operating Co LLC

Community/Retail Pharmacy in Sioux City, IA · enumerated 2006 · authorized official Micael Bettiga, Sr. Vice President Health Services.

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

National Provider Identifier

1407807118

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Registry record

Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 3025 Hamilton Blvd, Sioux City, IA, 51104
Fax (712) 255-4784
Enumeration date May 15, 2006
Last updated in NPPES Jun 6, 2014

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
332H00000X Eyewear Supplier Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 514 (IA) Primary

Authorized official

Name Micael Bettiga
Title Sr. Vice President Health Services

Other identifiers

Identifier Type State Issuer
8531562 Medicaid SD -
9164712 Medicaid SD -
0495028 Medicaid IA -
1613531 Other - NCPDP NUMBER
41098505408 Medicaid NE -
8531560 Medicaid SD -
10025413500 Medicaid NE -
0208470 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 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).

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-06-06.