Shopko Stores Operating Co LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SHOPKO STORES OPERATING CO LLC

Doing business as

Shopko Pharmacy 523

Practice address

525 E Highway 20
Valentine, NE 69201-2115

Phone

(402) 376-3531

Fax

(402) 376-3560

NPI assigned

Nov 1, 2007

Last updated

May 1, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael Bettiga, RPH

Title

Executive Vice President & Coo

Phone

(920) 429-4297

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shopko Pharmacy 523 Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Shopko Stores Operating Co LLC

  dba Shopko Pharmacy 718

  • Community/Retail Pharmacy
  • Liberty, KY
  • NPI 1508819384

  Member Of

  NPD member

Locations (25 of 62)

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Duane Allen, R.PH.

  • Pharmacist
  • Kalkaska, MI
  • NPI 1770030488
  NPD (past)
• Barbara Ann Salmela, R.PH.

  • Pharmacist
  • Ishpeming, MI
  • NPI 1962466474
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398902400000",
    "number": "1053590588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E HIGHWAY 20",
            "city": "VALENTINE",
            "state": "NE",
            "postal_code": "692012115",
            "telephone_number": "402-376-3531",
            "fax_number": "402-376-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E HIGHWAY 20",
            "city": "VALENTINE",
            "state": "NE",
            "postal_code": "692012115",
            "telephone_number": "402-376-3531",
            "fax_number": "402-376-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2014-05-01",
        "status": "A",
        "authorized_official_last_name": "BETTIGA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT & COO",
        "authorized_official_telephone_number": "920-429-4297",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026193100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shopko Pharmacy 523",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Schlinz
• Andrea Schmitz
• Traci Schmitz
• Steven A. Senseney, M.D.
• Issis Paige Shipley
• Joyce Dawn Simmons, D.D.S., M.S.
• Lisa Ann Marie Sinnett
• Brittany Jade Slama
• Brittany Spieker, MS, RD, LMNT
• Brett Spotted Elk

• Community/Retail Pharmacy in Valentine, NE
• Providers in Valentine, NE by specialty
• Community/Retail Pharmacy in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.