SHOPKO PHARMACY 164
NPI 1407807308
Pharmacy - Community/Retail Pharmacy in Dubuque, IA

Active since May 15, 2006
255 JOHN F KENNEDY RD, DUBUQUE, IA 52002(563) 583-5808(563) 583-5804 Get Directions Write a Review

NPPES record last updated: August 14, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Shopko Pharmacy 164 NPPES

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

SHOPKO PHARMACY 164 (NPI 1407807308) is a healthcare organization registered as a community/retail pharmacy in Dubuque, Iowa 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

NPI1407807308
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address255 JOHN F KENNEDY RDDubuque, IA 52002-5313
Mailing Address255 John F Kennedy RdDubuque, IA 52002-5313 · (563) 583-5808 · Fax (563) 583-5804
Fax(563) 583-5804
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 15, 2006
Last NPPES UpdateAugust 14, 2008
NPI 1407807308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in IA · 1070
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
255 JOHN F KENNEDY RD, Dubuque, IA 52002

Other Names 1

Doing Business AsShopko Pharmacy 164

Other Identifiers 8

Medicare ID-Type Unspecified0154160275
Medicaid0495309IA
Medicaid=========006IL
Medicaid0181107IA
Medicare NSC5695760118
Medicaid33236500WI
Medicaid410985054164IL
Other1619696Ncpdp Number

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.

Eyewear Supplier
255 JOHN F KENNEDY RD
DUBUQUE, IA 52002
Optometrist
255 JOHN F KENNEDY RD
DUBUQUE, IA 52002

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407807308, enumerated as an "organization" on May 15, 2006.

The provider is located at 255 JOHN F KENNEDY RD DUBUQUE, IA 52002 and the phone number is (563) 583-5808.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.