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Shopko Stores Operating Co LLC

Shopko Stores Operating Co LLC is a healthcare organization registered as Community/Retail Pharmacy in Watertown, SD, holding Type 2 (organization) NPI 1962453845 since 2006. The authorized official on file is Michael Bettiga, Sr. Vice President Health Services.

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NPI 1962453845
Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 700 9TH AVE SE, Watertown, SD, 57201
Phone 6058822011
Fax 6058866715
Enumeration date 2006-05-15
Last updated in NPPES 2014-06-06

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
332H00000X Eyewear Supplier Secondary
3336C0003X Community/Retail Pharmacy Primary 1001907 SD

Other identifiers

Identifier Type State Issuer
8502832 Medicaid SD
8502830 Medicaid SD
4303880 Other NCPDP NUMBER
979757200 Medicaid MN
9165520 Medicaid SD
260433000 Medicaid MN
9165522 Medicaid SD
Copy-ready billing details
Provider: Shopko Stores Operating Co LLC
NPI: 1962453845
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 700 9TH AVE SE, Watertown, SD, 57201

Providers at this address

NPI Name Type Specialty Location
1942253711 Shopko Stores Operating Co. LLC Organization Eyewear Supplier Watertown, SD

Verify this record

Cross-check NPI 1962453845 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 2014-06-06. Verify at npiregistry.cms.hhs.gov.
Where is Shopko Stores Operating Co LLC located?
The practice location on file with NPPES is in Watertown, SD.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2014-06-06.