Shopko Institutional Care Services Co LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

SHOPKO INSTITUTIONAL CARE SERVICES CO LLC

Doing business as

Shopko RxCare

Practice address

3184 London Rd
Eau Claire, WI 54701-6834

Phone

(715) 832-3780

Fax

(715) 832-3766

NPI assigned

Jan 28, 2013

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 and Coo

Phone

(920) 429-4297

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Shopko RxCare 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 526

  • Community/Retail Pharmacy
  • Afton, WY
  • NPI 1891971719

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1811235781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3184 LONDON RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3184 LONDON RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016834",
            "telephone_number": "715-832-3780",
            "fax_number": "715-832-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO INSTITUTIONAL CARE SERVICES CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BETTIGA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT AND 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": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811235781",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "9191-42",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5133513",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shopko RxCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Larry Shingleton, PT
• Patrick A Shinners, MD
• Shelly Lynn Shipley, COTA
• Shook Family Dental LLC
• Randal E. Shook, DDS
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 024)
• Shopko Stores Operating Co. LLC (ShopKo Optical 024)
• Shoptikal LLC (Shopko Optical 4024)
• Ashley J. Short, RD CDE
• Mary Short, P,T.A.

• Long Term Care Pharmacy in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Long Term Care Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.