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SHOPKO PHARMACY 792
NPI 1265877435
Pharmacy - Community/Retail Pharmacy in Tomahawk, WI

Active since May 01, 2013
79 HOMETOWN DRIVE, TOMAHAWK, WI 54487(715) 453-5996 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 792 NPPES

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

SHOPKO PHARMACY 792 (NPI 1265877435) is a healthcare organization registered as a community/retail pharmacy in Tomahawk, Wisconsin and active in the NPI registry since May 2013. The organization lists Michael Bettiga, Executive Vice President And Coo, as its authorized official.

NPPES Registry Identity

NPI1265877435
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address79 HOMETOWN DRIVETomahawk, WI 54487-9998
Mailing Address79 Hometown DriveTomahawk, WI 54487-9998
Phone(715) 453-5996
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President And Coo · (920) 429-7297
Enumeration DateMay 1, 2013
Last NPPES UpdateNovember 18, 2013
✔ NPI 1265877435 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
79 HOMETOWN DRIVE, Tomahawk, WI 54487
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Other Names 1

Doing Business AsShopko Pharmacy 792

Other Identifiers 2

Medicaid1265877435WI
Medicare NSC5695760290WI

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 1265877435. It was assigned to this organization in the NPPES registry on May 1, 2013. The provider is doing business as Shopko Pharmacy 792.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 79 Hometown Drive, Tomahawk, WI 54487. The listed phone number is (715) 453-5996.

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.