Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shopko Stores Operating Co LLC

Organization Durable Medical Equipment & Medical Supplies · NPI 1003862442

Shopko Stores Operating Co LLC is a Durable Medical Equipment & Medical Supplies in Green Bay, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.

Licensed in
WI
In the registry since
2006
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2430 E Mason St
Green Bay, WI 54302-3759
Phone: (920) 468-6044
Fax: (920) 468-3490
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 8636042 (WI)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Eyewear Supplier Taxonomy 332H00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1003862442
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Pharmacy 004
NPI enumeratedMay 26, 2006
Last updated in NPPESFebruary 14, 2014
Mailing address2430 E Mason St, Green Bay, WI 54302-3759

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