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SHOPKO PHARMACY 031
NPI 1326094772
Pharmacy - Community/Retail Pharmacy in Kenosha, WI

Active since May 26, 2006
5300 52ND ST, KENOSHA, WI 53144(262) 658-8137(262) 658-8261 Get Directions Write a Review

NPPES record last updated: December 11, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Pharmacy 031 NPPES

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

SHOPKO PHARMACY 031 (NPI 1326094772) is a healthcare organization registered as a community/retail pharmacy in Kenosha, Wisconsin and active in the NPI registry since May 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1326094772
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address5300 52ND STKenosha, WI 53144-2310
Mailing Address5300 52nd StKenosha, WI 53144-2310 · (262) 658-8137 · Fax (262) 658-8261
Phone(262) 658-8137
Fax(262) 658-8261
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 26, 2006
Last NPPES UpdateDecember 11, 2013
✔ NPI 1326094772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in WI · 8596042
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 ListedEyewear SupplierTaxonomy 332H00000X
Also ListedPharmacyTaxonomy 333600000X
5300 52ND ST, Kenosha, WI 53144
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Other Names 1

Doing Business AsShopko Pharmacy 031

Other Identifiers 4

Medicare NSC5695760080
Medicaid33026400WI
Other5115337Ncpdp Number
Medicare ID-Type Unspecified0154160061

Other Providers at the Same Location NPPES 3

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

JAMES R KRIEGE O.D.
Optometrist
5300 52ND ST
KENOSHA, WI 53144
Kenosha County (262) 658-8119
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
5300 52ND ST
KENOSHA, WI 53144
Kenosha County (262) 658-8119
MRS. JESSICA R SERPE PHARM D
Pharmacy
5300 52ND ST
KENOSHA, WI 53144
Kenosha County (262) 658-8137

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 1326094772. It was assigned to this organization in the NPPES registry on May 26, 2006. The provider is doing business as Shopko Pharmacy 031.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 5300 52nd St, Kenosha, WI 53144. The listed phone number is (262) 658-8137.

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 11, 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.