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SHOPKO PHARMACY 107
NPI 1144271123
Pharmacy - Community/Retail Pharmacy in Bountiful, UT

Active since May 13, 2006
190 S 500 W, BOUNTIFUL, UT 84010(801) 295-6900(801) 292-9390 Get Directions Write a Review

NPPES record last updated: August 14, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Pharmacy 107 NPPES

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

SHOPKO PHARMACY 107 (NPI 1144271123) is a healthcare organization registered as a community/retail pharmacy in Bountiful, 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

NPI1144271123
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address190 S 500 WBountiful, UT 84010-8729
Mailing Address190 S 500 WBountiful, UT 84010-8729 · (801) 295-6900 · Fax (801) 292-9390
Phone(801) 295-6900
Fax(801) 292-9390
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 13, 2006
Last NPPES UpdateAugust 14, 2008
✔ NPI 1144271123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in UT · 1327381703
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
190 S 500 W, Bountiful, UT 84010
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Other Names 1

Doing Business AsShopko Pharmacy 107

Other Identifiers 5

Other4607339Ncpdp Number
Medicare ID-Type Unspecified0154160240
Medicaid=========011UT
Medicaid410985054215UT
Medicare NSC5695760039

Other Providers at the Same Location NPPES 3

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

SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
190 S 500 W
BOUNTIFUL, UT 84010
Davis County (801) 295-9200
SHAWN PAGE MURRAY O.D.
Optometrist
190 S 500 W
BOUNTIFUL, UT 84010
Davis County (801) 295-9200
MR. GARY ARVEL HALE R.PH
Pharmacist
190 S 500 W
BOUNTIFUL, UT 84010
Davis County (801) 295-6900

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 1144271123. It was assigned to this organization in the NPPES registry on May 13, 2006. The provider is doing business as Shopko Pharmacy 107.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 190 S 500 W, Bountiful, UT 84010. The listed phone number is (801) 295-6900.

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 August 14, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.