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SHOPKO STORES OPERATING CO LLC NPI 1477504793


NPI Information

NPI: 1477504793
Provider Name: SHOPKO STORES OPERATING CO LLC

Doing Business As: SHOPKO PHARMACY 082

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
5959 S STATE ST
MURRAY, UT
ZIP 84107
Phone: (801) 261-3737
Get Directions

SHOPKO STORES OPERATING CO LLC is a community/retail pharmacy pharmacy in Murray, 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 1477504793. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Pharmacy 082.

The provider's business location address is:

5959 S STATE ST
MURRAY, UT
ZIP 84107-222
Phone: (801) 261-3737
Fax: (801) 261-0702

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 5/12/2006 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
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail Pharmacy1313081703UTAHYes

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
1=========002MEDICAIDUTAH
20154160176MEDICARE ID-TYPE UNSPECIFIED
3410985054036MEDICAIDUTAH
44606680OTHERNCPDP NUMBER
55695760045MEDICARE 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: 11/14/2023

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