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SHOPKO PHARMACY 608
NPI 1922386275
Pharmacy - Community/Retail Pharmacy in Brillion, WI

Active since August 03, 2011
1010 W RYAN ST, BRILLION, WI 54110(920) 429-4243(920) 756-9262 Get Directions Write a Review

NPPES record last updated: February 8, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Pharmacy 608 NPPES

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

SHOPKO PHARMACY 608 (NPI 1922386275) is a healthcare organization registered as a community/retail pharmacy in Brillion, Wisconsin and active in the NPI registry since August 2011. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1922386275
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1010 W RYAN STBrillion, WI 54110-1079
Mailing Address1010 W Ryan StBrillion, WI 54110-0000 · (920) 756-2640 · Fax (920) 756-9262
Phone(920) 429-4243
Fax(920) 756-9262
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateAugust 3, 2011
Last NPPES UpdateFebruary 8, 2012
✔ NPI 1922386275 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
1010 W RYAN ST, Brillion, WI 54110
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Other Names 1

Doing Business AsShopko Pharmacy 608

Other Identifiers 2

Medicare NSC5695760155
Medicaid1922386275WI

Other Providers at the Same Location NPPES 3

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

MR. MARK ALAN RYSTICKEN RPH
Pharmacist
1010 W RYAN ST
BRILLION, WI 54110
Calumet County (920) 756-2640
SHOPKO STORES OPERATING CO LLC
Eyewear Supplier
1010 W RYAN ST
BRILLION, WI 54110
Calumet County (920) 756-2640
MICHAEL J MICKSCH RPH
Pharmacist
1010 W RYAN ST
BRILLION, WI 54110
Calumet County (920) 756-2640

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 1922386275. It was assigned to this organization in the NPPES registry on August 3, 2011. The provider is doing business as Shopko Pharmacy 608.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1010 W Ryan St, Brillion, WI 54110. The listed phone number is (920) 429-4243.

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 February 8, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.