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SHOPKO PHARMACY 504
NPI 1760665160
Pharmacy - Community/Retail Pharmacy in Appleton, WI

Active since December 10, 2007
W3208 VAN ROY RD, APPLETON, WI 54915(920) 111-1111 Get Directions Write a Review

NPPES record last updated: August 15, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Pharmacy 504 NPPES

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

SHOPKO PHARMACY 504 (NPI 1760665160) is a healthcare organization registered as a community/retail pharmacy in Appleton, Wisconsin and active in the NPI registry since December 2007. The organization lists Michael Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1760665160
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location AddressW3208 VAN ROY RDAppleton, WI 54915
Mailing AddressW3208 Van Roy RdAppleton, WI 54915
Phone(920) 111-1111
Organization SubpartNo
Authorized OfficialMichael BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateDecember 10, 2007
Last NPPES UpdateAugust 15, 2008
✔ NPI 1760665160 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
W3208 VAN ROY RD, Appleton, WI 54915
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Other Names 1

Doing Business AsShopko Pharmacy 504

Other Identifiers 2

Medicaid36227000WI
Medicare NSC5695760140

Other Providers at the Same Location NPPES 5

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

SHOPKO STORES OPERATING CO LLC
Eyewear Supplier
W3208 VAN ROY RD
APPLETON, WI 54915
Calumet County (920) 111-1111
SARAH MICHALSKI
Pharmacist
W3208 VAN ROY RD
APPLETON, WI 54915
Calumet County (920) 733-3846
MRS. CHRISTINE ANNETTE KLAWITER NP-C
Nurse Practitioner (Family)
W3208 VAN ROY RD
APPLETON, WI 54915
Calumet County (866) 455-8111
DR. NATHAN PAUL CICHOCKI RPH
Pharmacist
W3208 VAN ROY RD
APPLETON, WI 54915
Calumet County (920) 733-3846
MRS. SAMANTHA A EITING APNP
Nurse Practitioner
W3208 VAN ROY RD
APPLETON, WI 54915
Calumet County (866) 455-8111

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 1760665160. It was assigned to this organization in the NPPES registry on December 10, 2007. The provider is doing business as Shopko Pharmacy 504.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at W3208 Van Roy Rd, Appleton, WI 54915. The listed phone number is (920) 111-1111.

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 15, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.