SHOPKO PHARMACY 025
NPI 1538113303
Pharmacy - Community/Retail Pharmacy in Marshall, MN

Active since May 19, 2006
1200 SUSAN DR, MARSHALL, MN 56258(507) 537-9650(507) 537-9646 Get Directions Write a Review

NPPES record last updated: August 27, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Pharmacy 025 NPPES

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

SHOPKO PHARMACY 025 (NPI 1538113303) is a healthcare organization registered as a community/retail pharmacy in Marshall, Minnesota 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

NPI1538113303
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1200 SUSAN DRMarshall, MN 56258-2580
Mailing Address1200 Susan DrMarshall, MN 56258-2580 · (507) 537-9650 · Fax (507) 537-9646
Fax(507) 537-9646
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 19, 2006
Last NPPES UpdateAugust 27, 2013
NPI 1538113303 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 MN · 2627999
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 ListedEyewear SupplierTaxonomy 332H00000X
1200 SUSAN DR, Marshall, MN 56258

Other Names 1

Doing Business AsShopko Pharmacy 025

Other Identifiers 5

Medicaid318117000MN
Other2421028Ncpdp Number
Medicare ID-Type Unspecified0154160165
Medicare NSC5695760092
Medicaid769015100MN

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.

Optometrist
1200 SUSAN DR
MARSHALL, MN 56258
Eyewear Supplier
1200 SUSAN DR
MARSHALL, MN 56258
Pharmacist
1200 SUSAN DR
MARSHALL, MN 56258

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 1538113303. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider is doing business as Shopko Pharmacy 025.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1200 Susan Dr, Marshall, MN 56258. The listed phone number is (507) 537-9650.

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 August 27, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.