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SHOPKO PHARMACY 003
NPI 1982659157
Pharmacy - Community/Retail Pharmacy in Manitowoc, WI

Active since May 24, 2006
3415 CALUMET AVE, MANITOWOC, WI 54220(920) 684-0251(920) 684-7706 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 003 NPPES

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

SHOPKO PHARMACY 003 (NPI 1982659157) is a healthcare organization registered as a community/retail pharmacy in Manitowoc, 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

NPI1982659157
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address3415 CALUMET AVEManitowoc, WI 54220-5427
Mailing Address3415 Calumet AveManitowoc, WI 54220-5427 · (920) 684-0251 · Fax (920) 684-7706
Phone(920) 684-0251
Fax(920) 684-7706
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 24, 2006
Last NPPES UpdateJune 6, 2014
✔ NPI 1982659157 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 · 8598042
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
3415 CALUMET AVE, Manitowoc, WI 54220
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Other Names 1

Doing Business AsShopko Pharmacy 003

Other Identifiers 4

Medicare NSC5695760113
Medicaid33001100WI
Other5112874Ncpdp Number
Medicare ID-Type Unspecified0154160157

Other Providers at the Same Location NPPES 10

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

DR. DONALD JAMES DOMRATH O.D.
Optometrist
3415 CALUMET AVE
MANITOWOC, WI 54220
Manitowoc County (920) 683-2244
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
3415 CALUMET AVE
MANITOWOC, WI 54220
Manitowoc County (920) 683-2244
MR. PAUL ROBERT GRAY
Pharmacist
3415 CALUMET AVE
MANITOWOC, WI 54220
Manitowoc County (920) 684-0251
DR. BRIAN F COOK O.D.
Optometrist
3415 CALUMET AVE
MANITOWOC, WI 54220
Manitowoc County (920) 683-2244
RONALD DEMARK O.D.
Optometrist
3415 CALUMET AVE
MANITOWOC, WI 54220
Manitowoc County (920) 683-2244
MRS. SHERI L MCGLONE BC HIS
Hearing Instrument Specialist
3415 CALUMET AVE, EXELA HEARING SERVICES
MANITOWOC, WI 54220
Manitowoc County (920) 652-0190
MS. DEBRA ANN ST.PIERRE RPH
Pharmacist
3415 CALUMET AVE
MANITOWOC, WI 54220
Manitowoc County (920) 684-0251
JEFFREY PRITZL
Pharmacist
3415 CALUMET AVE
MANITOWOC, WI 54220
Manitowoc County (920) 684-0251

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 1982659157. It was assigned to this organization in the NPPES registry on May 24, 2006. The provider is doing business as Shopko Pharmacy 003.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 3415 Calumet Ave, Manitowoc, WI 54220. The listed phone number is (920) 684-0251.

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.