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SHOPKO PHARMACY 119
NPI 1376579334
Pharmacy - Community/Retail Pharmacy in Dixon, IL

Active since June 23, 2006
1350 N GALENA AVE, DIXON, IL 61021(815) 284-4127(815) 284-6094 Get Directions Write a Review

NPPES record last updated: August 14, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Pharmacy 119 NPPES

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

SHOPKO PHARMACY 119 (NPI 1376579334) is a healthcare organization registered as a community/retail pharmacy in Dixon, Illinois and active in the NPI registry since June 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1376579334
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1350 N GALENA AVEDixon, IL 61021-1010
Mailing Address1350 N Galena AveDixon, IL 61021-1010 · (815) 284-4127 · Fax (815) 284-6094
Phone(815) 284-4127
Fax(815) 284-6094
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateJune 23, 2006
Last NPPES UpdateAugust 14, 2008
✔ NPI 1376579334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in IL · 05401587
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
1350 N GALENA AVE, Dixon, IL 61021
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Other Names 1

Doing Business AsShopko Pharmacy 119

Other Identifiers 5

Medicaid=========008IL
Medicare ID-Type Unspecified0154160211
Other1463809Ncpdp Number
Medicaid410985054001IL
Medicare NSC5695760131

Other Providers at the Same Location NPPES 2

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

DR. THOMAS KENNETH BIALECKE OD
Optometrist
1350 N GALENA AVE
DIXON, IL 61021
Lee County (815) 284-3935
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
1350 N GALENA AVE
DIXON, IL 61021
Lee County (815) 284-3935

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 1376579334. It was assigned to this organization in the NPPES registry on June 23, 2006. The provider is doing business as Shopko Pharmacy 119.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1350 N Galena Ave, Dixon, IL 61021. The listed phone number is (815) 284-4127.

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 August 14, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.