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SHOPKO PHARMACY 611
NPI 1073884458
Pharmacy - Community/Retail Pharmacy in Saint Peter, MN

Active since January 18, 2012
1002 OLD MINNESOTA AVE, SAINT PETER, MN 56082(507) 931-4410(507) 931-5434 Get Directions Write a Review

NPPES record last updated: November 18, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Pharmacy 611 NPPES

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

SHOPKO PHARMACY 611 (NPI 1073884458) is a healthcare organization registered as a community/retail pharmacy in Saint Peter, Minnesota and active in the NPI registry since January 2012. The organization lists Michael Bettiga, Executive Vice President And Coo, as its authorized official.

NPPES Registry Identity

NPI1073884458
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1002 OLD MINNESOTA AVESaint Peter, MN 56082-2023
Mailing Address1002 Old Minnesota AveSaint Peter, MN 56082-2023 · (507) 931-4410 · Fax (507) 931-5434
Phone(507) 931-4410
Fax(507) 931-5434
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President And Coo · (920) 429-4297
Enumeration DateJanuary 18, 2012
Last NPPES UpdateNovember 18, 2013
✔ NPI 1073884458 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
1002 OLD MINNESOTA AVE, Saint Peter, MN 56082
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Other Names 1

Doing Business AsShopko Pharmacy 611

Other Identifiers 2

Medicare NSC5695760157
Medicaid1073884458MN

Other Providers at the Same Location NPPES 4

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

CHRISTOPHER CAVEN PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1002 OLD MINNESOTA AVE
SAINT PETER, MN 56082
Nicollet County (507) 995-0260
MRS. NOELLE HOWE RPH.
Pharmacist
1002 OLD MINNESOTA AVE
SAINT PETER, MN 56082
Nicollet County (507) 931-4410
CHRISTOPHER D DANIELS R.PH.
Pharmacist
1002 OLD MINNESOTA AVE
SAINT PETER, MN 56082
Nicollet County (507) 931-4410
HY-VEE INC
Pharmacy (Community/Retail Pharmacy)
1002 OLD MINNESOTA AVE
SAINT PETER, MN 56082
Nicollet County (515) 267-2800

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 1073884458. It was assigned to this organization in the NPPES registry on January 18, 2012. The provider is doing business as Shopko Pharmacy 611.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1002 Old Minnesota Ave, Saint Peter, MN 56082. The listed phone number is (507) 931-4410.

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 November 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.