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Shopko Stores Operating Co LLC — NPI 1083887012, Dwight, IL | NPI Central

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NPI 1083887012

OrganizationActive

Shopko Stores Operating Co LLC

NPI 1083887012 · Community/Retail Pharmacy · Dwight, IL

Provider details

NPI number: 1083887012
Entity type: Organization
Primary specialty: Community/Retail PharmacySuppliers
Organization subpart: No
Authorized official: Michael Bettiga, Executive Vice President & Coo(920) 429-4297

Specialties & taxonomies

Community/Retail PharmacyPrimary3336C0003X
Suppliers
Durable Medical Equipment & Medical Supplies332B00000X
Suppliers
Pharmacy333600000X
Suppliers

Practice location

110 Watters Dr

Dwight, IL 60420-2200

Phone: (815) 584-3330

Approximate (ZIP-level) locationGet directions

More IL providers

Mailing address

110 Watters Dr

Dwight, IL 60420-2200

Other names (DBA / former)

Doing business as: Shopko Pharmacy 641

Registry dates

Enumerated: 2008-04-10
Last updated: 2012-09-28

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.