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Shopko Stores Operating Co LLC

Shopko Stores Operating Co LLC is a healthcare organization registered as Community/Retail Pharmacy in Wayne, NE, holding Type 2 (organization) NPI 1750333134 since 2006. The authorized official on file is Michael Bettiga, Executive Vice President & Coo.

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NPI 1750333134
Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 615 DEARBORN ST, Wayne, NE, 68787
Phone 4023752079
Fax 4023752082
Enumeration date 2006-05-16
Last updated in NPPES 2012-09-12

Authorized official

Name Michael Bettiga
Title Executive Vice President & Coo
Phone 9204294297

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
0565648 Medicaid IA
10024985800 Medicaid NE
2816582 Other NCPDP
0721878 Medicaid IA
10025416100 Medicaid NE
Copy-ready billing details
Provider: Shopko Stores Operating Co LLC
NPI: 1750333134
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 615 DEARBORN ST, Wayne, NE, 68787

Verify this record

Cross-check NPI 1750333134 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 Wayne, NE.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2012-09-12. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2012-09-12.