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SHOPKO PHARMACY 629
NPI 1629021514
Pharmacy - Community/Retail Pharmacy in Ely, MN

Active since May 19, 2006
1500 E SHERIDAN ST, ELY, MN 55731(218) 365-7123(218) 365-7124 Get Directions Write a Review

NPPES record last updated: August 21, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Pharmacy 629 NPPES

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

SHOPKO PHARMACY 629 (NPI 1629021514) is a healthcare organization registered as a community/retail pharmacy in Ely, Minnesota and active in the NPI registry since May 2006. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1629021514
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1500 E SHERIDAN STEly, MN 55731-1229
Mailing Address1500 E Sheridan StEly, MN 55731-1229 · (218) 365-7123 · Fax (218) 365-7124
Phone(218) 365-7123
Fax(218) 365-7124
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateMay 19, 2006
Last NPPES UpdateAugust 21, 2012
✔ NPI 1629021514 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
1500 E SHERIDAN ST, Ely, MN 55731
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Other Names 1

Doing Business AsShopko Pharmacy 629

Other Identifiers 3

Medicare NSC5695760172
Medicare PIN730000017
Other0459230078Medicare Id - Type Unspecified

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.

JEANANN DAWN LARSON RPH
Pharmacist
1500 E SHERIDAN ST
ELY, MN 55731
St. Louis County (218) 365-7123
ASHLEY MARY WALTON DOCTOR OF PHARMACY
Pharmacist
1500 E SHERIDAN ST
ELY, MN 55731
St. Louis County (218) 365-7123

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 1629021514. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider is doing business as Shopko Pharmacy 629.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1500 E Sheridan St, Ely, MN 55731. The listed phone number is (218) 365-7123.

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 21, 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.