Shopko Stores Operating Co Llc
Community/Retail Pharmacy
800 E Maes Ave, Kimberly
Wisconsin, 54136-1527
920-788-9154 920-788-3255
Shopko Stores Operating Co Llc is a Community/Retail Pharmacy in Kimberly, Wisconsin. It is located at 800 E Maes Ave, Kimberly and it's customer support contact number is 920-788-9154. The authorized person of Shopko Stores Operating Co Llc is Mr. Michael J Bettiga, RPH who is Sr. Vice President Health Services of the pharmacy and his contact number is 920-429-4297. Active license number of Shopko Stores Operating Co Llc is 8622042 for Community/Retail Pharmacy in Wisconsin. Shopko Stores Operating Co Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Shopko Stores Operating Co Llc is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Shopko Stores Operating Co Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Shopko Stores Operating Co Llc |
| Type: | Community/Retail Pharmacy |
| Location: | 800 E Maes Ave, Kimberly,
Wisconsin, 54136-1527 |
| Phone: | 920-788-9154 |
| Fax: | 920-788-3255 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Michael J Bettiga |
| Credentials: | RPH |
| Position: | Sr. Vice President Health Services |
| Contact Number: | 920-429-4297 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1083660435 |
| NPI Enumeration Date: | 26 May, 2006 |
| NPI Last Update On: | 22 May, 2014 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Shopko Stores Operating Co Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 8622042 | Wisconsin | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Pharmacy | | | Secondary | |
| Eyewear Supplier (equipment, Not The Service) | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 5114549 | Other | | Ncpdp Number |
| 33017200 | Medicaid | Wisconsin | |
Medicare Enrollment:
Shopko Stores Operating Co Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 0749292639 | O20100930005539 | Shopko Stores Operating Co Llc | DME SUPPLIER - PHARMACY |
Products Available:
Shopko Stores Operating Co Llc has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Diabetic Shoes & Inserts: Prefabricated |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 800 E Maes Ave,
Kimberly, Wisconsin |
| Zip: | 54136-1527 |
| Phone Number: | 920-788-9154 |
| Fax Number: | 920-788-3255 |
Patients can reach Shopko Stores Operating Co Llc at
800 E Maes Ave, Kimberly, Wisconsin or can
call on customer care at 920-788-9154.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.