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 1790711737

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

Licensed in
IL
In the registry since
2006
Specialties on file
2
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

3030 Wabash Ave
Springfield, IL 62704-6413
Phone: (217) 698-9614
Fax: (217) 546-1761
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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 054015896 (IL)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1790711737
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Pharmacy 150
NPI enumeratedJune 23, 2006
Last updated in NPPESAugust 14, 2008
Mailing address3030 Wabash Ave, Springfield, IL 62704-6413

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