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SHOPKO PHARMACY 510
NPI 1558618595
Pharmacy - Community/Retail Pharmacy in Waupaca, WI

Active since August 09, 2012
800 RIVERSIDE DR, WAUPACA, WI 54981(715) 256-1115(715) 256-1105 Get Directions Write a Review

NPPES record last updated: October 29, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Pharmacy 510 NPPES

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

SHOPKO PHARMACY 510 (NPI 1558618595) is a healthcare organization registered as a community/retail pharmacy in Waupaca, 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

NPI1558618595
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address800 RIVERSIDE DRWaupaca, WI 54981-1943
Mailing Address800 Riverside DrWaupaca, WI 54981-1943
Phone(715) 256-1115
Fax(715) 256-1105
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateAugust 9, 2012
Last NPPES UpdateOctober 29, 2012
✔ NPI 1558618595 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
800 RIVERSIDE DR, Waupaca, WI 54981
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Other Names 1

Doing Business AsShopko Pharmacy 510

Other Identifiers 2

Medicaid1558618595WI
Medicare NSC5695760234

Other Providers at the Same Location NPPES 20

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

THEDACARE MEDICAL CENTER - WAUPACA, INC.
General Acute Care Hospital (Critical Access)
800 RIVERSIDE DR
WAUPACA, WI 54981
Waupaca County (715) 258-1000
MR. BRUCE ALLEN PIERSON PT
Physical Therapist
800 RIVERSIDE DR
WAUPACA, WI 54981
Waupaca County (715) 258-1053
AMANDA DEBAUCHE OTR
Occupational Therapist
800 RIVERSIDE DR
WAUPACA, WI 54981
Waupaca County (715) 258-1053
AARON D. REINEKING PA
Physician Assistant
800 RIVERSIDE DR
WAUPACA, WI 54981
Waupaca County (715) 258-1300
THEDACARE MEDICAL CENTER - WAUPACA, INC.
General Acute Care Hospital (Critical Access)
800 RIVERSIDE DR
WAUPACA, WI 54981
Waupaca County (715) 258-1000
CHARLES D WASHINGTON M.D.
Emergency Medicine
800 RIVERSIDE DR
WAUPACA, WI 54981
Waupaca County (715) 258-1000
JASON BONFIGLIO PA
Physician Assistant
800 RIVERSIDE DR
WAUPACA, WI 54981
Waupaca County (715) 258-1000
MR. DEOGRACIAS R ESTRADA M.D.
Hospitalist
800 RIVERSIDE DR
WAUPACA, WI 54981
Waupaca County (715) 258-1000

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 1558618595. It was assigned to this organization in the NPPES registry on August 9, 2012. The provider is doing business as Shopko Pharmacy 510.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 800 Riverside Dr, Waupaca, WI 54981. The listed phone number is (715) 256-1115.

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 29, 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.