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SHOPKO PHARMACY 512
NPI 1609047869
Pharmacy - Community/Retail Pharmacy in Ellsworth, WI

Active since March 17, 2008
598 LUCAS LANE, ELLSWORTH, WI 54011(715) 273-4466(715) 273-5414 Get Directions Write a Review

NPPES record last updated: January 7, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Pharmacy 512 NPPES

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

SHOPKO PHARMACY 512 (NPI 1609047869) is a healthcare organization registered as a community/retail pharmacy in Ellsworth, Wisconsin and active in the NPI registry since March 2008. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1609047869
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address598 LUCAS LANEEllsworth, WI 54011
Mailing Address598 Lucas LaneEllsworth, WI 54011 · (715) 273-4466 · Fax (715) 273-5414
Phone(715) 273-4466
Fax(715) 273-5414
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateMarch 17, 2008
Last NPPES UpdateJanuary 7, 2013
✔ NPI 1609047869 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
598 LUCAS LANE, Ellsworth, WI 54011
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Other Names 1

Doing Business AsShopko Pharmacy 512

Other Identifiers 1

Medicare NSC5695760259

Other Providers at the Same Location NPPES

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

JUDY L DUMERMUTH R.PH.
Pharmacist
598 LUCAS LANE
ELLSWORTH, WI 54011
Pierce County (715) 273-4278

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 1609047869. It was assigned to this organization in the NPPES registry on March 17, 2008. The provider is doing business as Shopko Pharmacy 512.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 598 Lucas Lane, Ellsworth, WI 54011. The listed phone number is (715) 273-4466.

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 January 7, 2013. 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.