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 1790095099

Shopko Stores Operating Co LLC is a Durable Medical Equipment & Medical Supplies in Seymour, Wisconsin. Registered with an NPI since 2010.

In the registry since
2010
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

1010 S Mainline Dr
Seymour, WI 54165-1150
Phone: (920) 833-0430
Fax: (920) 833-7556
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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
Eyewear Supplier Taxonomy 332H00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1790095099
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Executive Vice President And Coo · (920) 429-4297
Other names Shopko Pharmacy 607
NPI enumeratedOctober 20, 2010
Last updated in NPPESDecember 9, 2011
Mailing address1010 S Mainline Dr, Seymour, WI 54165-1150

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