1. Home
  2. Directory
  3. Nebraska
  4. Broken Bow
  5. Pharmacy
  6. NPI Profile

SHOPKO PHARMACY 695
NPI 1174576763
Pharmacy - Community/Retail Pharmacy in Broken Bow, NE

Active since May 18, 2006
2353 SOUTH E, BROKEN BOW, NE 68822(308) 872-6818(308) 872-6889 Get Directions Write a Review

NPPES record last updated: January 23, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Pharmacy 695 NPPES

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

SHOPKO PHARMACY 695 (NPI 1174576763) is a healthcare organization registered as a community/retail pharmacy in Broken Bow, 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

NPI1174576763
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address2353 SOUTH EBroken Bow, NE 68822-2031
Mailing AddressPo Box 383Broken Bow, NE 68822-0383 · (308) 872-6818 · Fax (308) 872-6889
Phone(308) 872-6818
Fax(308) 872-6889
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateMay 18, 2006
Last NPPES UpdateJanuary 23, 2013
✔ NPI 1174576763 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
2353 SOUTH E, Broken Bow, NE 68822
Open in Google Maps ↗

Other Names 1

Doing Business AsShopko Pharmacy 695

Other Identifiers 5

Other2817003Ncpdp
Medicaid10025416500NE
Medicare NSC5695760263
Medicaid10025232800NE
Medicare PIN099877

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 1174576763. It was assigned to this organization in the NPPES registry on May 18, 2006. The provider is doing business as Shopko Pharmacy 695.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 2353 South E, Broken Bow, NE 68822. The listed phone number is (308) 872-6818.

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 January 23, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.