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SHOPKO PHARMACY 108
NPI 1053362038
Pharmacy - Community/Retail Pharmacy in Spanish Fork, UT

Active since May 13, 2006
955 N MAIN ST, SPANISH FORK, UT 84660(801) 798-3529(801) 798-1182 Get Directions Write a Review

NPPES record last updated: June 6, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Pharmacy 108 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOPKO PHARMACY 108 (NPI 1053362038) is a healthcare organization registered as a community/retail pharmacy in Spanish Fork, Utah and active in the NPI registry since May 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1053362038
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address955 N MAIN STSpanish Fork, UT 84660-1150
Mailing Address955 N Main StSpanish Fork, UT 84660-1150 · (801) 798-3529 · Fax (801) 798-1182
Phone(801) 798-3529
Fax(801) 798-1182
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 13, 2006
Last NPPES UpdateJune 6, 2014
✔ NPI 1053362038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in UT · 1327511703
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedEyewear SupplierTaxonomy 332H00000X
955 N MAIN ST, Spanish Fork, UT 84660
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Other Names 1

Doing Business AsShopko Pharmacy 108

Other Identifiers 5

Medicare NSC5695760038
Other4607341Ncpdp Number
Medicare ID-Type Unspecified0154160104
Medicaid410985054506UT
Medicaid=========012UT

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
955 N MAIN ST
SPANISH FORK, UT 84660
Utah County (801) 798-3557
DR. JERRY DALE CARLSON O.D.
Optometrist
955 N MAIN ST
SPANISH FORK, UT 84660
Utah County (801) 798-3557

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shopko Stores Operating Co LLC's NPI number?

The NPI number for Shopko Stores Operating Co LLC is 1053362038. It was assigned to this organization in the NPPES registry on May 13, 2006. The provider is doing business as Shopko Pharmacy 108.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 955 N Main St, Spanish Fork, UT 84660. The listed phone number is (801) 798-3529.

What is Shopko Stores Operating Co LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co LLC was last updated on June 6, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.