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SHOPKO PHARMACY 689
NPI 1477505519
Pharmacy - Community/Retail Pharmacy in Mount Ayr, IA

Active since May 17, 2006
201 N FILLMORE ST, MOUNT AYR, IA 50854(641) 464-4527(641) 464-4600 Get Directions Write a Review

NPPES record last updated: December 27, 2012. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Shopko Pharmacy 689 NPPES

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

SHOPKO PHARMACY 689 (NPI 1477505519) is a healthcare organization registered as a community/retail pharmacy in Mount Ayr, Iowa 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

NPI1477505519
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address201 N FILLMORE STMount Ayr, IA 50854-1627
Mailing Address201 N Fillmore StMount Ayr, IA 50854-1627 · (641) 464-4527 · Fax (641) 464-4600
Phone(641) 464-4527
Fax(641) 464-4600
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateDecember 27, 2012
✔ NPI 1477505519 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
201 N FILLMORE ST, Mount Ayr, IA 50854
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Other Names 1

Doing Business AsShopko Pharmacy 689

Other Identifiers 4

Medicare NSC5695760253
Medicaid0237503IA
Medicaid0495903IA
Other1620966Ncpdp

Other Providers at the Same Location NPPES

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

HY-VEE INC
Pharmacy (Community/Retail Pharmacy)
201 N FILLMORE ST
MOUNT AYR, IA 50854
Ringgold County (641) 464-3300

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 1477505519. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Pharmacy 689.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 201 N Fillmore St, Mount Ayr, IA 50854. The listed phone number is (641) 464-4527.

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 27, 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.