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SHOPKO PHARMACY 179
NPI 1811157662
Pharmacy - Community/Retail Pharmacy in North Branch, MN

Active since June 16, 2008
5630 ST CROIX TRAIL, NORTH BRANCH, MN 55056(651) 674-9956(651) 674-9907 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 179 NPPES

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

SHOPKO PHARMACY 179 (NPI 1811157662) is a healthcare organization registered as a community/retail pharmacy in North Branch, Minnesota and active in the NPI registry since June 2008. The organization lists Michael Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1811157662
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address5630 ST CROIX TRAILNorth Branch, MN 55056
Mailing Address5630 St Croix TrailNorth Branch, MN 55056 · (651) 674-9956 · Fax (651) 674-9907
Phone(651) 674-9956
Fax(651) 674-9907
Organization SubpartNo
Authorized OfficialMichael BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateJune 16, 2008
Last NPPES UpdateJuly 25, 2014
✔ NPI 1811157662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ 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 ListedEyewear SupplierTaxonomy 332H00000X
Also ListedPharmacyTaxonomy 333600000X
5630 ST CROIX TRAIL, North Branch, MN 55056
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Other Names 1

Doing Business AsShopko Pharmacy 179

Other Identifiers 3

Medicare NSC5695760143
Other2429226Ncpdp
Medicaid387482100MN

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
5630 ST CROIX TRAIL
NORTH BRANCH, MN 55056
Chisago County (651) 674-9951

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 1811157662. It was assigned to this organization in the NPPES registry on June 16, 2008. The provider is doing business as Shopko Pharmacy 179.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 5630 St Croix Trail, North Branch, MN 55056. The listed phone number is (651) 674-9956.

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.