1. Home
  2. Directory
  3. Wisconsin
  4. Grafton
  5. Pharmacy
  6. NPI Profile

SHOPKO PHARMACY 090
NPI 1740236199
Pharmacy - Community/Retail Pharmacy in Grafton, WI

Active since May 26, 2006
1771 WISCONSIN AVE, GRAFTON, WI 53024(262) 375-0016(262) 375-3519 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 090 NPPES

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

SHOPKO PHARMACY 090 (NPI 1740236199) is a healthcare organization registered as a community/retail pharmacy in Grafton, 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

NPI1740236199
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1771 WISCONSIN AVEGrafton, WI 53024-2437
Mailing Address1771 Wisconsin AveGrafton, WI 53024-2437 · (262) 375-0016 · Fax (262) 375-3519
Phone(262) 375-0016
Fax(262) 375-3519
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 26, 2006
Last NPPES UpdateJune 6, 2014
✔ NPI 1740236199 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 · 8605042
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
1771 WISCONSIN AVE, Grafton, WI 53024
Open in Google Maps ↗

Other Names 1

Doing Business AsShopko Pharmacy 090

Other Identifiers 4

Other5119450Ncpdp Number
Medicaid33162200WI
Medicare NSC5695760010
Medicare ID-Type Unspecified0154160087

Other Providers at the Same Location NPPES 4

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

SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
1771 WISCONSIN AVE
GRAFTON, WI 53024
Ozaukee County (262) 375-0505
MR. WILLIAM F. PETZKE RPH
Pharmacist
1771 WISCONSIN AVE
GRAFTON, WI 53024
Ozaukee County (262) 375-0016
MR. ROBERT EDMUND MUCHA R.PH.
Pharmacist
1771 WISCONSIN AVE
GRAFTON, WI 53024
Ozaukee County (262) 375-0016
JENNIFER FORD
Pharmacist
1771 WISCONSIN AVE
GRAFTON, WI 53024
Ozaukee County (262) 375-0016

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 1740236199. It was assigned to this organization in the NPPES registry on May 26, 2006. The provider is doing business as Shopko Pharmacy 090.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1771 Wisconsin Ave, Grafton, WI 53024. The listed phone number is (262) 375-0016.

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.