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SHOPKO EXPRESS PHARMACY 502
NPI 1831144070
Pharmacy - Community/Retail Pharmacy in Green Bay, WI

Active since May 24, 2006
2585 LINEVILLE RD, GREEN BAY, WI 54313(920) 662-9450(920) 662-1912 Get Directions Write a Review

NPPES record last updated: May 22, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Express Pharmacy 502 NPPES

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

SHOPKO EXPRESS PHARMACY 502 (NPI 1831144070) is a healthcare organization registered as a community/retail pharmacy in Green Bay, 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

NPI1831144070
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address2585 LINEVILLE RDGreen Bay, WI 54313-7122
Mailing Address2585 Lineville RdGreen Bay, WI 54313-7122 · (920) 662-9450 · Fax (920) 662-1912
Phone(920) 662-9450
Fax(920) 662-1912
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 24, 2006
Last NPPES UpdateMay 22, 2014
✔ NPI 1831144070 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 · 8597042
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
2585 LINEVILLE RD, Green Bay, WI 54313
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Other Names 1

Doing Business AsShopko Express Pharmacy 502

Other Identifiers 4

Medicare ID-Type Unspecified0154160300
Other5128168Ncpdp Number
Medicare NSC5695760021
Medicaid33279000WI

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.

MR. DARRIN D WIRKES R.PH.
Pharmacist
2585 LINEVILLE RD, SHOPKO EXPRESS #502
GREEN BAY, WI 54313
Brown County (920) 662-9450
ORLANDO SIERRALTA
Pharmacist
2585 LINEVILLE RD
GREEN BAY, WI 54313
Brown County (920) 662-9450
DR. DAVID CLARK LIEBURN O.D.
Optometrist
2585 LINEVILLE RD
GREEN BAY, WI 54313
Brown County (920) 662-9450
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
2585 LINEVILLE RD
GREEN BAY, WI 54313
Brown County (920) 662-9450

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 1831144070. It was assigned to this organization in the NPPES registry on May 24, 2006. The provider is doing business as Shopko Express Pharmacy 502.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 2585 Lineville Rd, Green Bay, WI 54313. The listed phone number is (920) 662-9450.

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 May 22, 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.