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SHOPKO PHARMACY 052
NPI 1619928330
Pharmacy - Community/Retail Pharmacy in Mason City, IA

Active since May 15, 2006
615 S MONROE AVE, MASON CITY, IA 50401(641) 424-4302(641) 424-8537 Get Directions Write a Review

NPPES record last updated: June 6, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Pharmacy 052 NPPES

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

SHOPKO PHARMACY 052 (NPI 1619928330) is a healthcare organization registered as a community/retail pharmacy in Mason City, Iowa 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

NPI1619928330
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address615 S MONROE AVEMason City, IA 50401-5061
Mailing Address615 S Monroe AveMason City, IA 50401-5061 · (641) 424-4302 · Fax (641) 424-8537
Phone(641) 424-4302
Fax(641) 424-8537
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 15, 2006
Last NPPES UpdateJune 6, 2014
✔ NPI 1619928330 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 IA · 819
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
615 S MONROE AVE, Mason City, IA 50401
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Other Names 1

Doing Business AsShopko Pharmacy 052

Other Identifiers 7

Medicaid201016000MN
Medicaid743927000MN
Medicare ID-Type Unspecified0154160017
Other1614494Ncpdp Number
Medicaid0227249IA
Medicaid0495168IA
Medicare NSC5695760052

Other Providers at the Same Location NPPES 2

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

DR. GERRIE L LUBBEN O.D.
Optometrist
615 S MONROE AVE, SHOPKO EYECARE CENTER
MASON CITY, IA 50401
Cerro Gordo County (641) 424-8271
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
615 S MONROE AVE
MASON CITY, IA 50401
Cerro Gordo County (641) 424-8271

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 1619928330. It was assigned to this organization in the NPPES registry on May 15, 2006. The provider is doing business as Shopko Pharmacy 052.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 615 S Monroe Ave, Mason City, IA 50401. The listed phone number is (641) 424-4302.

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.