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 1265877435

Shopko Stores Operating Co LLC is a Durable Medical Equipment & Medical Supplies in Tomahawk, Wisconsin. Registered with an NPI since 2013.

In the registry since
2013
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

79 Hometown Dr
Tomahawk, WI 54487-9998
Phone: (715) 453-5996
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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
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1265877435
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Executive Vice President And Coo · (920) 429-7297
Other names Shopko Pharmacy 792
NPI enumeratedMay 1, 2013
Last updated in NPPESNovember 18, 2013
Mailing address79 Hometown Drive, Tomahawk, WI 54487-9998

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