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 1407127889

Shopko Stores Operating Co LLC is a Durable Medical Equipment & Medical Supplies in Lake Mills, Wisconsin. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

203 N Main St
Lake Mills, WI 53551-1610
Phone: (920) 648-3455
Fax: (920) 648-2712
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 number1407127889
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Executive Vice President And Coo · (920) 429-4297
Other names Shopko Pharmacy 612
NPI enumeratedJanuary 18, 2012
Last updated in NPPESApril 20, 2012
Mailing address203 N Main St, Lake Mills, WI 53551-1610

Other providers in Lake Mills