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SHOPKO PHARMACY 772
NPI 1124067095
Pharmacy - Community/Retail Pharmacy in Powell, WY

Active since June 06, 2006
1005 W COULTER AVE, POWELL, WY 82435(307) 754-2755(307) 754-7915 Get Directions Write a Review

NPPES record last updated: October 19, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Pharmacy 772 NPPES

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

SHOPKO PHARMACY 772 (NPI 1124067095) is a healthcare organization registered as a community/retail pharmacy in Powell, Wyoming and active in the NPI registry since June 2006. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1124067095
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1005 W COULTER AVEPowell, WY 82435-2530
Mailing Address1005 W Coulter AvePowell, WY 82435-2530 · (307) 754-2755 · Fax (307) 754-7915
Phone(307) 754-2755
Fax(307) 754-7915
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateJune 6, 2006
Last NPPES UpdateOctober 19, 2012
✔ NPI 1124067095 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
1005 W COULTER AVE, Powell, WY 82435
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Other Names 1

Doing Business AsShopko Pharmacy 772

Other Identifiers 6

Medicaid117709500WY
Medicare PINW21599
Medicare NSC5695760226
Medicaid123286001WY
Other5203776Ncpdp
Medicaid123286000WY

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.

ALBERTSONS LLC
Pharmacy (Community/Retail Pharmacy)
1005 W COULTER AVE
POWELL, WY 82435
Park County (307) 271-3160
TAYLOR OLSON PHARMD
Pharmacist
1005 W COULTER AVE
POWELL, WY 82435
Park County (307) 271-3160
JASON LEE BISCHOFF
Pharmacist
1005 W COULTER AVE
POWELL, WY 82435
Park County (307) 754-2755
RAMSEY LAMB RPH
Pharmacist
1005 W COULTER AVE
POWELL, WY 82435
Park County (307) 271-3160

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 1124067095. It was assigned to this organization in the NPPES registry on June 6, 2006. The provider is doing business as Shopko Pharmacy 772.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1005 W Coulter Ave, Powell, WY 82435. The listed phone number is (307) 754-2755.

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 19, 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.