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SHOPKO PHARMACY 742
NPI 1447203799
Pharmacy - Community/Retail Pharmacy in East Grand Forks, MN

Active since May 18, 2006
421 GATEWAY DR NE, EAST GRAND FORKS, MN 56721(218) 773-0940(218) 773-1049 Get Directions Write a Review

NPPES record last updated: October 9, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Pharmacy 742 NPPES

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

SHOPKO PHARMACY 742 (NPI 1447203799) is a healthcare organization registered as a community/retail pharmacy in East Grand Forks, Minnesota 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

NPI1447203799
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address421 GATEWAY DR NEEast Grand Forks, MN 56721-1619
Mailing Address421 Gateway Dr NeEast Grand Forks, MN 56721-1619 · (218) 773-0940 · Fax (218) 773-1049
Phone(218) 773-0940
Fax(218) 773-1049
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateMay 18, 2006
Last NPPES UpdateOctober 9, 2012
✔ NPI 1447203799 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
421 GATEWAY DR NE, East Grand Forks, MN 56721
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Other Names 1

Doing Business AsShopko Pharmacy 742

Other Identifiers 5

Medicare NSC5695760212
Other2419009Ncpdp
Medicaid775560100MN
Medicare ID-Type Unspecified0459230001
Medicaid272498000MN

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 1447203799. It was assigned to this organization in the NPPES registry on May 18, 2006. The provider is doing business as Shopko Pharmacy 742.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 421 Gateway Dr NE, East Grand Forks, MN 56721. The listed phone number is (218) 773-0940.

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 9, 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.