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Shopko Stores Operating Co LLC

Shopko Stores Operating Co LLC is a healthcare organization registered as Community/Retail Pharmacy in Appleton, WI, holding Type 2 (organization) NPI 1811943269 since 2006. The authorized official on file is Michael Bettiga, Sr. Vice President Health Services.

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NPI 1811943269
Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 1000 W NORTHLAND AVE, Appleton, WI, 54914
Phone 9207396871
Fax 9207316167
Enumeration date 2006-05-26
Last updated in NPPES 2014-01-21

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 8592042 WI

Other identifiers

Identifier Type State Issuer
5111290 Other NCPDP NUMBER
33129400 Medicaid WI
Copy-ready billing details
Provider: Shopko Stores Operating Co LLC
NPI: 1811943269
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 1000 W NORTHLAND AVE, Appleton, WI, 54914

Providers at this address

NPI Name Type Specialty Location
1417908955 Lawrence Johansen Individual Optometrist Appleton, WI
1225089139 Craig Taylor Individual Optometrist Appleton, WI
1295787315 Shopko Stores Operating Co. LLC Organization Eyewear Supplier Appleton, WI
1881646636 Kathryn Korth Individual Optometrist Appleton, WI
1215281050 Jessica Haufschildt Individual Pharmacist Appleton, WI
1972857514 Jean Flesch Individual Pharmacist Appleton, WI
1558704569 Alison Piette Individual Pharmacist Appleton, WI
1619313533 Stephan Opacich Individual Pharmacist Appleton, WI

Verify this record

Cross-check NPI 1811943269 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

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2014-01-21. Verify at npiregistry.cms.hhs.gov.
Where is Shopko Stores Operating Co LLC located?
The practice location on file with NPPES is in Appleton, WI.

Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2014-01-21.