SHOPKO PHARMACY 641
NPI 1083887012
Pharmacy - Community/Retail Pharmacy in Dwight, IL

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

The NPI number for Shopko Stores Operating Co LLC is 1083887012. It was assigned to this organization in the NPPES registry on April 10, 2008. The provider is doing business as Shopko Pharmacy 641.

Q: 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.

Active since April 10, 2008

110 WATTERS DR, DWIGHT, IL 60420(815) 584-3330 Get Directions Write a Review

NPPES record last updated: September 28, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Shopko Pharmacy 641 NPPES

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

SHOPKO PHARMACY 641 (NPI 1083887012) is a healthcare organization registered as a community/retail pharmacy in Dwight, Illinois and active in the NPI registry since April 2008. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1083887012

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameSHOPKO STORES OPERATING CO LLC

Location Address110 WATTERS DRDwight, IL 60420-2200

Mailing Address110 Watters DrDwight, IL 60420-2200 · (815) 584-3330

Phone(815) 584-3330

Organization SubpartNo

Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297

Enumeration DateApril 10, 2008

Last NPPES UpdateSeptember 28, 2012

✔ NPI 1083887012 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

110 WATTERS DR, Dwight, IL 60420

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Other Names 1

Doing Business AsShopko Pharmacy 641

Other Identifiers 1

Medicare NSC5695760201

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 1083887012. It was assigned to this organization in the NPPES registry on April 10, 2008. The provider is doing business as Shopko Pharmacy 641.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 110 Watters Dr, Dwight, IL 60420. The listed phone number is (815) 584-3330.

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 September 28, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.