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SHOPKO PHARMACY 127
NPI 1568418911
Pharmacy - Community/Retail Pharmacy in Delavan, WI

Active since May 26, 2006
1450 E GENEVA ST, DELAVAN, WI 53115(262) 728-0062(262) 728-0055 Get Directions Write a Review

NPPES record last updated: June 6, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Pharmacy 127 NPPES

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

SHOPKO PHARMACY 127 (NPI 1568418911) is a healthcare organization registered as a community/retail pharmacy in Delavan, Wisconsin 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

NPI1568418911
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1450 E GENEVA STDelavan, WI 53115-2025
Mailing Address1450 E Geneva StDelavan, WI 53115-2025 · (262) 728-0062 · Fax (262) 728-0055
Phone(262) 728-0062
Fax(262) 728-0055
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 26, 2006
Last NPPES UpdateJune 6, 2014
✔ NPI 1568418911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in WI · 8625042
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
Also ListedPharmacyTaxonomy 333600000X
1450 E GENEVA ST, Delavan, WI 53115
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Other Names 1

Doing Business AsShopko Pharmacy 127

Other Identifiers 4

Medicaid33203400WI
Medicare ID-Type Unspecified0154160234
Other5122231Ncpdp
Medicare NSC5695760111

Other Providers at the Same Location NPPES 5

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

RICHARD HALL R.PH.
Pharmacist
1450 E GENEVA ST
DELAVAN, WI 53115
Walworth County (262) 728-0062
DR. JAMES WINCHESTER WALLACE O.D.
Optometrist
1450 E GENEVA ST
DELAVAN, WI 53115
Walworth County (262) 728-0068
DR. ANNE-MARIE CHRISTINE LASCHEN O.D.
Optometrist
1450 E GENEVA ST
DELAVAN, WI 53115
Walworth County (262) 728-0068
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
1450 E GENEVA ST
DELAVAN, WI 53115
Walworth County (262) 728-0068
MARK J EGGERICHS R.PH.
Pharmacist
1450 E GENEVA ST
DELAVAN, WI 53115
Walworth County (262) 728-0062

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 1568418911. It was assigned to this organization in the NPPES registry on May 26, 2006. The provider is doing business as Shopko Pharmacy 127.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1450 E Geneva St, Delavan, WI 53115. The listed phone number is (262) 728-0062.

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 June 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.