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 1811941586

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

In the registry since
2006
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

N2585 Plaza Rd
Wautoma, WI 54982-7706
Phone: (920) 787-2090
Fax: (920) 787-4605
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 number1811941586
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Executive Vice President & Coo · (920) 429-4297
Other names Shopko Pharmacy 617
NPI enumeratedMay 19, 2006
Last updated in NPPESSeptember 4, 2012
Mailing addressN2585 Plaza Rd, Wautoma, WI 54982-7706

Other providers in Wautoma