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 1891014635

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

Licensed in
WI
In the registry since
2010
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

802 N Main St
Kewaunee, WI 54216-0274
Phone: (920) 388-2231
Fax: (920) 388-2459
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 9006-042 (WI)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1891014635
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Executive Vice President And Coo · (920) 429-4297
Other names Shopko Pharmacy 601
NPI enumeratedMay 19, 2010
Last updated in NPPESSeptember 22, 2010
Mailing address802 N Main St, Po Box 274, Kewaunee, WI 54216-0274

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