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 1063466852

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

Licensed in
MN
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

1755 N Humiston Ave
Worthington, MN 56187-1757
Phone: (507) 376-9309
Fax: (507) 372-7840
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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 2628040 (MN)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Eyewear Supplier Taxonomy 332H00000X

Record details

NPI number1063466852
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Pharmacy 058
NPI enumeratedMay 19, 2006
Last updated in NPPESJanuary 21, 2014
Mailing address1755 N Humiston Ave, Worthington, MN 56187-1757

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