Provider Type Icon

SHOPKO STORES OPERATING CO LLC NPI 1053362038


NPI Information

NPI: 1053362038
Provider Name: SHOPKO STORES OPERATING CO LLC

Doing Business As: SHOPKO PHARMACY 108

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
955 N MAIN ST
SPANISH FORK, UT
ZIP 84660
Phone: (801) 798-3529
Get Directions

SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in Spanish Fork, UT. 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 1053362038. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 108.

The provider's business location address is:

955 N MAIN ST
SPANISH FORK, UT
ZIP 84660-150
Phone: (801) 798-3529
Fax: (801) 798-1182

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 5/13/2006 and was last updated on 6/6/2014.


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 Pharmacy1327511703UTAHYes

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
15695760038MEDICARE NSC
24607341OTHERNCPDP NUMBER
30154160104MEDICARE ID-TYPE UNSPECIFIED
4410985054506MEDICAIDUTAH
5=========012MEDICAIDUTAH

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.