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SHOPKO PHARMACY 059
NPI 1972557767
Pharmacy - Community/Retail Pharmacy in Fairmont, MN

Active since May 19, 2006
1001 HIGHWAY 15 S, FAIRMONT, MN 56031(507) 238-9488(507) 238-9038 Get Directions Write a Review

NPPES record last updated: June 11, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Pharmacy 059 NPPES

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

SHOPKO PHARMACY 059 (NPI 1972557767) is a healthcare organization registered as a community/retail pharmacy in Fairmont, Minnesota 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

NPI1972557767
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1001 HIGHWAY 15 SFairmont, MN 56031-4456
Mailing Address1001 Highway 15 SFairmont, MN 56031-4456 · (507) 238-9488 · Fax (507) 238-9038
Phone(507) 238-9488
Fax(507) 238-9038
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 19, 2006
Last NPPES UpdateJune 11, 2014
✔ NPI 1972557767 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 MN · 2628053
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
1001 HIGHWAY 15 S, Fairmont, MN 56031
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Other Names 1

Doing Business AsShopko Pharmacy 059

Other Identifiers 7

Medicaid1972557767IA
Other2416748Ncpdp Number
Medicaid854687000MN
Medicaid969857400MN
Medicaid662688200MN
Medicare NSC5695760095
Medicare ID-Type Unspecified0154160023

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.

KARMEN DATHER RPH
Pharmacist
1001 HIGHWAY 15 S
FAIRMONT, MN 56031
Martin County (507) 238-9488
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
1001 HIGHWAY 15 S
FAIRMONT, MN 56031
Martin County (507) 238-9490
JOSEPH BUNDY OD
Optometrist
1001 HIGHWAY 15 S
FAIRMONT, MN 56031
Martin County (507) 238-9490
CARLY STEIER
Pharmacist
1001 HIGHWAY 15 S
FAIRMONT, MN 56031
Martin County (507) 238-9488

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 1972557767. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider is doing business as Shopko Pharmacy 059.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1001 Highway 15 S, Fairmont, MN 56031. The listed phone number is (507) 238-9488.

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 11, 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.