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SHOPKO PHARMACY 789
NPI 1265780464
Pharmacy - Community/Retail Pharmacy in Waupaca, WI

Active since August 17, 2012
825 W FULTON ST, WAUPACA, WI 54981(715) 258-7621(715) 258-6880 Get Directions Write a Review

NPPES record last updated: December 4, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Pharmacy 789 NPPES

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

SHOPKO PHARMACY 789 (NPI 1265780464) is a healthcare organization registered as a community/retail pharmacy in Waupaca, Wisconsin and active in the NPI registry since August 2012. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1265780464
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address825 W FULTON STWaupaca, WI 54981-1471
Mailing Address825 W Fulton StWaupaca, WI 54981-1471
Phone(715) 258-7621
Fax(715) 258-6880
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateAugust 17, 2012
Last NPPES UpdateDecember 4, 2012
✔ NPI 1265780464 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
825 W FULTON ST, Waupaca, WI 54981
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Other Names 1

Doing Business AsShopko Pharmacy 789

Other Identifiers 2

Medicaid1265780464WI
Medicare NSC5695760233

Other Providers at the Same Location NPPES 6

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

MR. RANDALL LILJEGREN R.PH.
Pharmacist
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (715) 258-9000
DR. NIKITA GEORGE TONGAS DDS
Dentist (General Practice)
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (920) 731-7445
JAMES BERT BASZYNSKI RPH
Pharmacist
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (715) 258-9000
PARTNERSHIP COMMUNITY HEALTH CENTER, INC
Clinic/Center (Federally Qualified Health Center (FQHC))
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (920) 731-7445
MELISSA A FLEASE RDH
Dental Hygienist
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (920) 731-7445
SHOPKO STORES OPERATING CO.,LLC
Eyewear Supplier
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (715) 258-9000

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 1265780464. It was assigned to this organization in the NPPES registry on August 17, 2012. The provider is doing business as Shopko Pharmacy 789.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 825 W Fulton St, Waupaca, WI 54981. The listed phone number is (715) 258-7621.

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 December 4, 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.