SHOPKO PHARMACY 654
NPI 1396797403
Pharmacy - Community/Retail Pharmacy in Archbold, OH

Q: What is Shopko Stores Operating Co LLC's NPI number?

The NPI number for Shopko Stores Operating Co LLC is 1396797403. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Pharmacy 654.

Q: 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.

Active since May 17, 2006

2015 S DEFIANCE ST, ARCHBOLD, OH 43502(419) 445-0052(419) 445-0053 Get Directions Write a Review

NPPES record last updated: October 22, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Shopko Pharmacy 654 NPPES

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

SHOPKO PHARMACY 654 (NPI 1396797403) is a healthcare organization registered as a community/retail pharmacy in Archbold, Ohio 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

NPI1396797403

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameSHOPKO STORES OPERATING CO LLC

Location Address2015 S DEFIANCE STArchbold, OH 43502-9111

Mailing Address2015 S Defiance StArchbold, OH 43502-9111 · (419) 445-0052 · Fax (419) 445-0053

Phone(419) 445-0052

Fax(419) 445-0053

Organization SubpartNo

Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297

Enumeration DateMay 17, 2006

Last NPPES UpdateOctober 22, 2012

✔ NPI 1396797403 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

2015 S DEFIANCE ST, Archbold, OH 43502

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Other Names 1

Doing Business AsShopko Pharmacy 654

Other Identifiers 3

Medicaid2183551OH

Other3668069Ncpdp Number

Medicare NSC5695760229

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 1396797403. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Pharmacy 654.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 2015 S Defiance St, Archbold, OH 43502. The listed phone number is (419) 445-0052.

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 October 22, 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.