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 1902852353

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

Licensed in
WI
In the registry since
2006
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

822 Park Ave
Beaver Dam, WI 53916-2266
Phone: (920) 887-7461
Fax: (920) 887-0725
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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 8633042 (WI)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Eyewear Supplier Taxonomy 332H00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1902852353
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Pharmacy 014
NPI enumeratedMay 26, 2006
Last updated in NPPESJune 6, 2014
Mailing address822 Park Ave, Beaver Dam, WI 53916-2266

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