Provider Type Icon

SHOPKO STORES OPERATING CO LLC NPI 1659316107


NPI Information

NPI: 1659316107
Provider Name: SHOPKO STORES OPERATING CO LLC

Doing Business As: SHOPKO PHARMACY 096

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
55 LAKE BLVD
REDDING, CA
ZIP 96003
Phone: (530) 241-0713
Get Directions

SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in Redding, CA. 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 1659316107. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 096.

The provider's business location address is:

55 LAKE BLVD
REDDING, CA
ZIP 96003-500
Phone: (530) 241-0713
Fax: (530) 241-1447

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 6/18/2006 and was last updated on 8/14/2008.


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
13336C0003XPharmacyCommunity/Retail PharmacyPHY47484CALIFORNIAYes

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
10598194OTHERNCPDP NUMBER
2QN4PHA474840MEDICAIDCALIFORNIA
30154160117MEDICARE ID-TYPE UNSPECIFIED
41ZXPHA358300MEDICAIDCALIFORNIA
5MFGPHA376480MEDICAIDCALIFORNIA
6PHA474840MEDICAIDCALIFORNIA
7PHA376480MEDICAIDCALIFORNIA
85695760129MEDICARE NSC

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.