SHOPKO PHARMACY 647
NPI 1013946250
Pharmacy - Community/Retail Pharmacy in Syracuse, IN

Active since July 01, 2006
1101 N INDIANA AVE, SYRACUSE, IN 46567(574) 457-3109(574) 457-3186 Get Directions Write a Review

NPPES record last updated: October 15, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Pharmacy 647 NPPES

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

SHOPKO PHARMACY 647 (NPI 1013946250) is a healthcare organization registered as a community/retail pharmacy in Syracuse, Indiana and active in the NPI registry since July 2006. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1013946250
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1101 N INDIANA AVESyracuse, IN 46567-1019
Mailing Address1101 N Indiana AveSyracuse, IN 46567-1019 · (574) 457-3109 · Fax (574) 457-3186
Fax(574) 457-3186
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateJuly 1, 2006
Last NPPES UpdateOctober 15, 2012
NPI 1013946250 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
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
1101 N INDIANA AVE, Syracuse, IN 46567

Other Names 1

Doing Business AsShopko Pharmacy 647

Other Identifiers 4

Medicaid200445250AIN
Medicare NSC5695760216
Other1536690Ncpdp
Medicare ID-Type Unspecified0459230115

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 1013946250. It was assigned to this organization in the NPPES registry on July 1, 2006. The provider is doing business as Shopko Pharmacy 647.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1101 N Indiana Ave, Syracuse, IN 46567. The listed phone number is (574) 457-3109.

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 October 15, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.