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SHOPKO PHARMACY 142
NPI 1699726588
Pharmacy - Community/Retail Pharmacy in Fort Madison, IA

Active since May 15, 2006
4810 AVENUE O, FORT MADISON, IA 52627(319) 372-8629(319) 372-8698 Get Directions Write a Review

NPPES record last updated: July 25, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Pharmacy 142 NPPES

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

SHOPKO PHARMACY 142 (NPI 1699726588) is a healthcare organization registered as a community/retail pharmacy in Fort Madison, 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

NPI1699726588
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address4810 AVENUE OFort Madison, IA 52627-9677
Mailing Address4810 Avenue OFort Madison, IA 52627-9677 · (319) 372-8629 · Fax (319) 372-8698
Phone(319) 372-8629
Fax(319) 372-8698
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 15, 2006
Last NPPES UpdateJuly 25, 2014
✔ NPI 1699726588 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 · 1040
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
4810 AVENUE O, Fort Madison, IA 52627
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Other Names 1

Doing Business AsShopko Pharmacy 142

Other Identifiers 8

Medicare ID-Type Unspecified1249550009
Other1619266Ncpdp Number
Medicaid=========010IL
Medicaid0154160255MO
Medicaid0438168IA
Medicaid0495093IA
Medicaid371110040142IL
Medicare NSC5695760070

Other Providers at the Same Location NPPES

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

SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
4810 AVENUE O
FORT MADISON, IA 52627
Lee County (319) 372-8633

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 1699726588. It was assigned to this organization in the NPPES registry on May 15, 2006. The provider is doing business as Shopko Pharmacy 142.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 4810 Avenue O, Fort Madison, IA 52627. The listed phone number is (319) 372-8629.

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 July 25, 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.