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SHOPKO PHARMACY 788
NPI 1497003594
Pharmacy - Community/Retail Pharmacy in Columbus, WI

Active since August 21, 2012
200 COMMERCE DR, COLUMBUS, WI 53925(920) 623-2700(920) 623-3749 Get Directions Write a Review

NPPES record last updated: December 4, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Pharmacy 788 NPPES

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

SHOPKO PHARMACY 788 (NPI 1497003594) is a healthcare organization registered as a community/retail pharmacy in Columbus, Wisconsin and active in the NPI registry since August 2012. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1497003594
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address200 COMMERCE DRColumbus, WI 53925-9567
Mailing Address200 Commerce DrColumbus, WI 53925-9567
Phone(920) 623-2700
Fax(920) 623-3749
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateAugust 21, 2012
Last NPPES UpdateDecember 4, 2012
✔ NPI 1497003594 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
200 COMMERCE DR, Columbus, WI 53925
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Other Names 1

Doing Business AsShopko Pharmacy 788

Other Identifiers 2

Medicare NSC5695760247
Medicaid1497003594WI

Other Providers at the Same Location NPPES 3

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

MR. NICHOLAS L SHARROW RPH
Pharmacist
200 COMMERCE DR
COLUMBUS, WI 53925
Columbia County (920) 623-9183
JAMINE KURTH
Pharmacist
200 COMMERCE DR
COLUMBUS, WI 53925
Columbia County (920) 623-9183
SHOPKO STORES OPERATING CO LLC
Eyewear Supplier
200 COMMERCE DR
COLUMBUS, WI 53925
Columbia County (920) 429-7137

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 1497003594. It was assigned to this organization in the NPPES registry on August 21, 2012. The provider is doing business as Shopko Pharmacy 788.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 200 Commerce Dr, Columbus, WI 53925. The listed phone number is (920) 623-2700.

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 4, 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.