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SHOPKO STORES OPERATING CO LLC NPI 1003855057


NPI Information

NPI: 1003855057
Provider Name: SHOPKO STORES OPERATING CO LLC

Doing Business As: SHOPKO PHARMACY 066

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
9520 N NEWPORT HWY
SPOKANE, WA
ZIP 99218
Phone: (509) 466-7414
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SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in Spokane, WA. The provider 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. SHOPKO STORES OPERATING CO LLC NPI is 1003855057. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 066.

The provider's business location address is:

9520 N NEWPORT HWY
SPOKANE, WA
ZIP 99218-219
Phone: (509) 466-7414
Fax: (509) 466-0546

The provider's authorized official is Michael J Bettiga .
The authorized official title is Sr. Vice President Health Services and has the following contact phone number (920) 429-4297.

The enumeration date for this NPI number is 6/5/2006 and was last updated on 8/28/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2332H00000XEyewear SupplierNo
33336C0003XPharmacyCommunity/Retail PharmacyCF00058644WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14918275OTHERNCPDP NUMBER
25695760076MEDICARE NSC
30006004071MEDICAIDWASHINGTON
40215797OTHERWA LABOR & INDUSTRY
51111590021MEDICARE ID-TYPE UNSPECIFIED
60013174OTHERWA LABOR & INDUSTRY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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