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

Shopko Stores Operating Co LLC

Organization Durable Medical Equipment & Medical Supplies · NPI 1013946250

Shopko Stores Operating Co LLC is a Durable Medical Equipment & Medical Supplies in Syracuse, Indiana. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3
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

1101 N Indiana Ave
Syracuse, IN 46567-1019
Phone: (574) 457-3109
Fax: (574) 457-3186
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1013946250
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Executive Vice President & Coo · (920) 429-4297
Other names Shopko Pharmacy 647
NPI enumeratedJuly 1, 2006
Last updated in NPPESOctober 15, 2012
Mailing address1101 N Indiana Ave, Syracuse, IN 46567-1019

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