OrganizationActive
Shopko Stores Operating Co LLC
NPI 1124067095 · Community/Retail Pharmacy · Powell, WY
Shopko Stores Operating Co LLC is a Community/Retail Pharmacy organization in Powell, WY (NPI 1124067095).
Provider details
- NPI number
- 1124067095
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Michael Bettiga, Executive Vice President & Coo(920) 429-4297
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1005 W Coulter Ave
Powell, WY 82435-2530
Phone: (307) 754-2755
Fax: (307) 754-7915
Approximate (ZIP-level) locationGet directions
Mailing address
1005 W Coulter Ave
Powell, WY 82435-2530
Other names (DBA / former)
- Doing business as
- Shopko Pharmacy 772
Registry dates
- Enumerated
- 2006-06-06
- Last updated
- 2012-10-19
Frequently asked questions
- What is Shopko Stores Operating Co LLC's NPI number?
- Shopko Stores Operating Co LLC's National Provider Identifier (NPI) is 1124067095, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shopko Stores Operating Co LLC?
- Shopko Stores Operating Co LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Shopko Stores Operating Co LLC located?
- Shopko Stores Operating Co LLC's practice location on file with NPPES is 1005 W Coulter Ave, Powell, WY 82435-2530.
- What is Shopko Stores Operating Co LLC's phone number?
- The practice phone number listed in the NPPES registry for Shopko Stores Operating Co LLC is (307) 754-2755.
- Who is the authorized official for Shopko Stores Operating Co LLC?
- The authorized official listed on Shopko Stores Operating Co LLC's NPPES record is Michael Bettiga, Executive Vice President & Coo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shopko Stores Operating Co LLC's NPI active?
- Yes — Shopko Stores Operating Co LLC's NPI (1124067095) is active in the NPPES registry as of the last update on 2012-10-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.