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SHOPKO PHARMACY 015
NPI 1811943269
Pharmacy - Community/Retail Pharmacy in Appleton, WI

Active since May 26, 2006
1000 W NORTHLAND AVE, APPLETON, WI 54914(920) 739-6871(920) 731-6167 Get Directions Write a Review

NPPES record last updated: January 21, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Pharmacy 015 NPPES

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

SHOPKO PHARMACY 015 (NPI 1811943269) is a healthcare organization registered as a community/retail pharmacy in Appleton, 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

NPI1811943269
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1000 W NORTHLAND AVEAppleton, WI 54914-1419
Mailing Address1000 W Northland AveAppleton, WI 54914-1419 · (920) 739-6871 · Fax (920) 731-6167
Phone(920) 739-6871
Fax(920) 731-6167
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 26, 2006
Last NPPES UpdateJanuary 21, 2014
✔ NPI 1811943269 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 · 8592042
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
1000 W NORTHLAND AVE, Appleton, WI 54914
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Other Names 1

Doing Business AsShopko Pharmacy 015

Other Identifiers 4

Other5111290Ncpdp Number
Medicare ID-Type Unspecified0154160180
Medicaid33129400WI
Medicare NSC5695760061

Other Providers at the Same Location NPPES 7

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

JESSICA LYNN HAUFSCHILDT RPH.
Pharmacist
1000 W NORTHLAND AVE
APPLETON, WI 54914
Outagamie County (920) 739-6871
DR. CRAIG S. TAYLOR SR. O.D.
Optometrist
1000 W NORTHLAND AVE
APPLETON, WI 54914
Outagamie County (920) 731-4511
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
1000 W NORTHLAND AVE
APPLETON, WI 54914
Outagamie County (920) 731-4511
DR. LAWRENCE JOHANSEN O.D.
Optometrist
1000 W NORTHLAND AVE
APPLETON, WI 54914
Outagamie County (920) 731-4511
ALISON M PIETTE PHARM.D
Pharmacist
1000 W NORTHLAND AVE
APPLETON, WI 54914
Outagamie County (920) 739-6871
MR. STEPHAN OPACICH RPH
Pharmacist
1000 W NORTHLAND AVE
APPLETON, WI 54914
Outagamie County (920) 739-6871
DR. KATHRYN ANN KORTH O.D., F.A.A.O.
Optometrist
1000 W NORTHLAND AVE, SHOPKO OPTICAL
APPLETON, WI 54914
Outagamie County (920) 731-4511

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 1811943269. It was assigned to this organization in the NPPES registry on May 26, 2006. The provider is doing business as Shopko Pharmacy 015.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1000 W Northland Ave, Appleton, WI 54914. The listed phone number is (920) 739-6871.

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 January 21, 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.