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 1215983663

Shopko Stores Operating Co LLC is a Durable Medical Equipment & Medical Supplies in Wausau, 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

200 S 18th Ave
Wausau, WI 54401-4252
Phone: (715) 842-7737
Fax: (715) 848-8773
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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 8615042 (WI)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Eyewear Supplier Taxonomy 332H00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1215983663
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Pharmacy 079
NPI enumeratedMay 26, 2006
Last updated in NPPESJune 11, 2014
Mailing address200 S 18th Ave, Wausau, WI 54401-4252

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