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SHOPKO PHARMACY 518
NPI 1003869025
Pharmacy - Community/Retail Pharmacy in Pine City, MN

Active since May 19, 2006
100 EVERGREEN SQ SW, PINE CITY, MN 55063(320) 629-3003(320) 629-2987 Get Directions Write a Review

NPPES record last updated: July 31, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Pharmacy 518 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOPKO PHARMACY 518 (NPI 1003869025) is a healthcare organization registered as a community/retail pharmacy in Pine City, Minnesota and active in the NPI registry since May 2006. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1003869025
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address100 EVERGREEN SQ SWPine City, MN 55063-2000
Mailing Address100 Evergreen Sq SwPine City, MN 55063-2000 · (320) 629-3003 · Fax (320) 629-2987
Phone(320) 629-3003
Fax(320) 629-2987
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateMay 19, 2006
Last NPPES UpdateJuly 31, 2012
✔ NPI 1003869025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in MN · 262789-2
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
100 EVERGREEN SQ SW, Pine City, MN 55063
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Other Names 1

Doing Business AsShopko Pharmacy 518

Other Identifiers 3

Medicare NSC5695760161
Other2418829Ncpdp
Medicare ID-Type Unspecified0459230007

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMBER L CALLAHAN PHARMD.
Pharmacist
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-3003
UMAIR REHMAN MD
Family Medicine
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-6721
FAIRVIEW CLINICS
Clinic/Center (Primary Care)
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-6721
KATHRYN MARVIN NP
Nurse Practitioner (Family)
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-6721
WHITNEY RENE MOULTON DPT
Physical Therapist
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-8575
MRS. ADRIANA ADDISON FNP-BC
Nurse Practitioner (Family)
100 EVERGREEN SQ SW
PINE CITY, MN 55063
Pine County (320) 629-6721

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shopko Stores Operating Co LLC's NPI number?

The NPI number for Shopko Stores Operating Co LLC is 1003869025. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider is doing business as Shopko Pharmacy 518.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 100 Evergreen Sq SW, Pine City, MN 55063. The listed phone number is (320) 629-3003.

What is Shopko Stores Operating Co LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co LLC was last updated on July 31, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.