SHOPKO PHARMACY 657
NPI 1063465854
Pharmacy - Community/Retail Pharmacy in Blair, NE

Active since May 19, 2006
150 S 1ST ST, BLAIR, NE 68008(402) 426-9189(402) 426-9190 Get Directions Write a Review

NPPES record last updated: August 28, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Pharmacy 657 NPPES

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

SHOPKO PHARMACY 657 (NPI 1063465854) is a healthcare organization registered as a community/retail pharmacy in Blair, Nebraska 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

NPI1063465854
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address150 S 1ST STBlair, NE 68008-2540
Mailing AddressPo Box 1450Minneapolis, MN 55485-5891 · (402) 426-9189 · Fax (402) 426-9190
Fax(402) 426-9190
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateMay 19, 2006
Last NPPES UpdateAugust 28, 2012
NPI 1063465854 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
150 S 1ST ST, Blair, NE 68008

Other Names 1

Doing Business AsShopko Pharmacy 657

Other Identifiers 7

Medicaid0973404IA
Medicaid0721886IA
Medicaid47062642603NE
Other2814689Ncpdp
Medicare NSC5695760179
Other0459230047Medicare Id - Type Unspecified
Medicaid10025417400NE

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 1063465854. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider is doing business as Shopko Pharmacy 657.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 150 S 1st St, Blair, NE 68008. The listed phone number is (402) 426-9189.

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 August 28, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.