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Shopko Stores Operating Co LLC

Shopko Stores Operating Co LLC is a healthcare organization registered as Community/Retail Pharmacy in Eau Claire, WI, holding Type 2 (organization) NPI 1720034176 since 2006. The authorized official on file is Michael Bettiga, Sr. Vice President Health Services.

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NPI 1720034176
Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 955 W CLAIREMONT AVE, Eau Claire, WI, 54701
Phone 7158328336
Fax 7158325484
Enumeration date 2006-05-26
Last updated in NPPES 2014-04-16

Authorized official

Name Michael Bettiga
Title Sr. Vice President Health Services
Phone 9204294297

Taxonomy & classification

Taxonomy code Specialty Primary License State
332B00000X Durable Medical Equipment & Medical Supplies Secondary
333600000X Pharmacy Secondary
332H00000X Eyewear Supplier Secondary
3336C0003X Community/Retail Pharmacy Primary 8594042 WI

Other identifiers

Identifier Type State Issuer
33007800 Medicaid WI
5113496 Other NCPDP NUMBER
Copy-ready billing details
Provider: Shopko Stores Operating Co LLC
NPI: 1720034176
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 955 W CLAIREMONT AVE, Eau Claire, WI, 54701

Providers at this address

NPI Name Type Specialty Location
1962755074 Constance Brandner Individual Pharmacist Eau Claire, WI
1508200155 Wilson Lane Individual Pharmacist Eau Claire, WI
1730616129 Nicholas Konwinski Individual Optometrist Eau Claire, WI

Verify this record

Cross-check NPI 1720034176 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

Where is Shopko Stores Operating Co LLC located?
The practice location on file with NPPES is in Eau Claire, WI.
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.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2014-04-16.