Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Shopko Stores Operating Co LLC

Community/Retail Pharmacy in Fairmont, MN · 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

1972557767

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Registry record

Entity type Organization (Type 2)

Legal business name Shopko Stores Operating Co LLC

Other name <Unavail>

Practice address 1001 Highway 15 S, Fairmont, MN, 56031

Phone (507) 238-9488

Fax (507) 238-9038

Enumeration date May 19, 2006

Last updated in NPPES Jun 11, 2014

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary

332H00000X Eyewear Supplier Suppliers Secondary

3336C0003X Community/Retail Pharmacy Suppliers · License 2628053 (MN) Primary

Authorized official

Name Michael Bettiga

Title Sr. Vice President Health Services

Phone (920) 429-4297

Other identifiers

Identifier	Type	State	Issuer
1972557767	Medicaid	IA	—
2416748	Other	—	NCPDP NUMBER
969857400	Medicaid	MN	—
854687000	Medicaid	MN	—
662688200	Medicaid	MN	—

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 → Validate an NPI →

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 2014-06-11. Verify at npiregistry.cms.hhs.gov.

Where is Shopko Stores Operating Co LLC located?

The practice location on file with NPPES is in Fairmont, MN.

Providers at this address

Browse all →

Shopko Stores Operating Co. LLC Eyewear Supplier · Fairmont, MN NPI 1457304024 Joseph Bundy Optometrist · Fairmont, MN NPI 1598829111 Karmen Dather Pharmacist · Fairmont, MN NPI 1356769087 Carly Steier Pharmacist · Fairmont, MN NPI 1871911594

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-06-11.