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SHOPKO PHARMACY 054
NPI 1962453845
Pharmacy - Community/Retail Pharmacy in Watertown, SD

Active since May 15, 2006
700 9TH AVE SE, WATERTOWN, SD 57201(605) 882-2011(605) 886-6715 Get Directions Write a Review

NPPES record last updated: June 6, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Pharmacy 054 NPPES

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

SHOPKO PHARMACY 054 (NPI 1962453845) is a healthcare organization registered as a community/retail pharmacy in Watertown, South Dakota 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

NPI1962453845
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address700 9TH AVE SEWatertown, SD 57201-5222
Mailing Address700 9th Ave SeWatertown, SD 57201-5222 · (605) 882-2011 · Fax (605) 886-6715
Phone(605) 882-2011
Fax(605) 886-6715
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 15, 2006
Last NPPES UpdateJune 6, 2014
✔ NPI 1962453845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in SD · 1001907
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
700 9TH AVE SE, Watertown, SD 57201
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Other Names 1

Doing Business AsShopko Pharmacy 054

Other Identifiers 9

Medicare ID-Type Unspecified0154160129
Medicaid8502832SD
Other4303880Ncpdp Number
Medicaid260433000MN
Medicaid9165520SD
Medicaid8502830SD
Medicaid979757200MN
Medicaid9165522SD
Medicare NSC5695760072

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
700 9TH AVE SE
WATERTOWN, SD 57201
Codington County (605) 882-2021

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 1962453845. It was assigned to this organization in the NPPES registry on May 15, 2006. The provider is doing business as Shopko Pharmacy 054.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 700 9th Ave SE, Watertown, SD 57201. The listed phone number is (605) 882-2011.

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 June 6, 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.