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Shopko Stores Operating Co LLC

Community/Retail Pharmacy in Menasha, WI · 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

1508812959

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Registry record

Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 1578 Appleton Rd, Menasha, WI, 54952
Fax (920) 722-3195
Enumeration date May 26, 2006
Last updated in NPPES Apr 16, 2014

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
332H00000X Eyewear Supplier Suppliers Secondary
333600000X Pharmacy Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 8628042 (WI) Primary

Authorized official

Name Michael Bettiga
Title Sr. Vice President Health Services

Other identifiers

Identifier Type State Issuer
33031600 Medicaid WI
5115779 Other NCPDP NUMBER

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 2014-04-16. Verify at npiregistry.cms.hhs.gov.
Where is Shopko Stores Operating Co LLC located?
The practice location on file with NPPES is in Menasha, WI.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-04-16.